Background To date,pharmacologic therapy is considered the standard first-line treatment for insomnia disorder,but there are still some concerns over the adverse reactions.Repetitive transcranial magnetic stimulation(rTMS)and cognitive behavioral therapy for insomnia(CBT-I)as an alternative to pharmacologic therapy have the advantages of fewer side effects and better patient tolerance in the treatment of chronic insomnia disorder.Objective To explore the clinical efficacy of rTMS and CBT-I on chronic insomnia disorder,so as to provide a novel therapeutic option for the treatment of chronic insomnia disorder.Methods A total of 50 patients with chronic insomnia disorder attending the outpatient clinic of Inner Mongolia Autonomous Region Mental Health Center or community hospital from September 21,2020 to December 16,2021 and fulfilling the International Classification of Sleep Disorders,third edition(ICSD-3)diagnostic criteria were enrolled.Additionally,16 age-and sex-matched healthy controls recruited from the community were set as control group.Patients were randomly divided into rTMS group and CBT-I group,25 cases in each group,and received rTMS or CBT-I intervention for 6 weeks respectively.At enrollment and completion of intervention,patients were subjected to Polysomnography(PSG),Pittsburgh Sleep Quality Index(PSQI),Insomnia Severity Index(ISI)and Repeatable Battery for the Assessment of Neuropsychological Status(RBANS).All participants underwent resting-state functional magnetic resonance imaging(rs-fMRI)scans,and amplitude of low-frequency fluctuation(ALFF)was calculated.The brain regions with statistically different ALFF values between patient group and control group were chosen as regions of interest(ROIs),and whole-brain seed-based functional connectivity analyses were conducted.Results After a 6-week intervention in the two groups,the main effect of time was significant for PSQI(F=41.160,P<0.05),ISI(F=69.615,P<0.05)and RBANS immediate memory(F=47.923,P<0.05),language(F=12.090,P<0.05)and delayed memory indices(F=28.193,P<0.05).A significant main effect of time for total sleep time(F=8.995,P<0.05),a significant main effect of time for sleep efficiency(F=12.414,P<0.05),a significant main effect of group for sleep efficiency(F=4.342,P<0.05)and a significant main effect of time for N1%(F=7.806,P<0.05)were observed.Sleep efficacy in CBT-I group improved significantly from pre-to post-test(t=-2.785,P<0.05).Patients in rTMS group showed increased functional connectivity between the orbital superior frontal gyrus and other regions including left lentiform nucleus putamen(t=4.991,P<0.05),right median cingulate and paracingulate gyri(t=4.471,P<0.05)and right postcentral gyrus(t=4.922,P<0.05),and increased functional connectivity between the orbital superior frontal gyrus and left middle frontal gyrus was found in CBT-I group(t=6.586,P<0.05).Conclusion rTMS and CBT-I may help alleviate insomnia and improve cognitive function of patients with chronic insomnia disorder.

[Objective] To evaluate the value of X-ray combined with MRI in the diagnosis of rotator cuff injury. [Methods] A retrospective study was conducted on the patients who underwent X-ray and MRI examinations at the First Affiliated Hospital of Air Force Medical University from January 2021 to March 2022. A total of 158 patients were recruited, among whom 146 had rotator cuff injury, 10 had rheumatoid arthritis, and 2 had shoulder joint space occupation. We compared the specificity, sensitivity, consistency, detection rate, missed diagnosis rate and misdiagnosis rate of various examinations, and compared the X-ray and MRI examination results. [Results] The sensitivity and specificity of X-ray for rotator cuff injury were 65.8% and 41.7%, those of MRI for rotator cuff injury were 78.1% and 66.7%, and those of the combined diagnosis were 93.8% and 83.3%, respectively. The Kappa value of the combined diagnosis of rotator cuff injury and surgical results was higher than that of X-ray and MRI diagnosis (P<0.05). The detection rate and missed diagnosis rate of the three groups differed significantly (χ²=6.095, 13.113, P<0.05). The detection rate of rotator cuff injury by the combined diagnosis was higher than that of X-ray and MRI diagnosis, and the missed diagnosis rate was lower than that of the latter (P>0.05). [Conclusion] The detection rate of rotator cuff injury of shoulder joint by the combined examination is higher than that of X-ray and MRI, and the rate of missed diagnosis and misdiagnosis is lower. The combined examination can provide detailed evaluation for preoperative diagnosis.

Objective To explore the prognostic value of pericoronary adipose tissue(PCAT)and coronary artery disease reporting and data system(CAD-RADS)for major adverse cardiovascular events(MACE)in patients with acute chest pain.Methods A total of 1 248 patients with acute chest pain referred for coronary computed tomography angiography(CCTA)were retrospectively selected and the occurrence of MACE was followed up.MACE included unstable angina requiring hospitalization,late coronary revascularization,non-fatal myocardial infarction,and all-cause death.Multivariable Cox regression analysis was used to analyze the relationship between patients'clinical characteristics,CAD-RADS,PCAT CT attenuation and MACE.Results Among 1 248 patients,142 patients(11.38％)experienced MACE.Multivariable Cox regression analysis showed that CAD-RADS categories 2-5[hazard ratio(HR)2.715-9.544;P＜0.001]and right coronary artery(RCA)PCAT CT attenuation(HR 1.028;P=0.019)were independent predictors of MACE after adjusting for clinical risk factors.After adding RCA PCAT CT attenuation on the basis of CAD-RADS,the risk stratification ability of patients was improved to a certain extent(overall x2 value:149.4 vs 157.1;P=0.053).Conclusion RCA PACT CT attenuation and CAD-RADS are independent predictors of MACE.However,adding RCA PCAT CT attenuation to CAD-RADS did not increase the prognostic value of MACE in acute chest pain patients.

Purpose To investigate the difference of cerebral blood flow between sleep deprivation and rest wakefulness.Materials and Methods Fifty subjects were recruited from universities in Xi'an from October 2020 to December 2021.The psychomotor vigilance test(PVT)task was used to measure sustained attention.Arterial spin labeling technique was used to analyze and compare the relative cerebral blood flow(rCBF)between sleep deprivation and rest wakefulness.The correlation between altered rCBF of specific brain regions and PVT task performance after sleep deprivation was analyzed.Results Compared with rest wakefulness,rCBF in bilateral dorsolateral prefrontal lobe,bilateral parietal lobule,left orbital middle frontal gyrus,bilateral middle temporal gyrus,right posterior central gyrus,and bilateral angular gyrus was significantly decreased after sleep deprivation.The rCBF of bilateral thalamus,left precuneus,right medial prefrontal lobe,left posterior cingulate gyrus,and left inferior temporal gyrus was significantly increased(FDR corrected,P<0.05,cluster size≥20 voxels).The changes of rCBF in left dorsolateral prefrontal lobe and right parietal lobule were significantly negatively correlated with the PVT task performance(r=-0.56,P<0.001;r=-0.64,P<0.001),and the change of rCBF of left precuneus was significantly positively correlated with the PVT task performance(r=0.72,P<0.001).Conclusion The abnormal changes of CBF in default mode network,frontoparietal network-related brain regions and thalamic may be the important neural mechanism of sustained attentional decline after sleep deprivation.

Objective To investigate the comparison of the clinical treatment efficacy of propafenone and amiodarone in patients with paroxysmal supraventricular tachycardia ( PSVT ) .Methods Retrospective a total of 89 patients with PSVT from June 2013 to June 2015 in our hospital were selected.According to the different administration methods, the patients were divided into the propafenone group of 46 cases and the amiodarone group of 43 cases.The changes of left ventricular end-systolic volume, left ventricular end-diastolic volume, ejection fraction, cardioversion success rate, mean cardioversion time, heart rate and side effects were compared.Results After treatment, the left ventricular end-systolic volume (52.31 ±8.34) mL/m2 , (54.28 ±7.23) mL/m2, left ventricular end-diastolic volume (47.31 ±8.56) mL/m2, (45.28 ±7.16) mL/m2 and ejection fraction (61.57 ± 0.76)%, (61.39 ±0.69)% were without significant differences.After treatment, the heart rates of the two groups were significantly decreased, the propafenone group ( 85.31 ±12.84 ) times/min, amiodarone group ( 87.26 ±11.95 ) times/min, and there were not significant differences.The recovery time of propafenone group was ( 19.34 ±4.76 ) , higher than the amiodarone group ( 25.69 ±6.09 ) ( P <0.05 ).But the success rate of cardioversion (52.17%) was lower than the amiodarone group (88.37%) (P<0.05).The side effect rates in the propafenone group (21.74%) was significantly higher than that in the amiodarone group ( 4.65%) ( P <0.05 ) .Conclusion Propafenone and amiodarone cardioversion PSVT have achieved good results, but propafenone rapid onset, the average cardioversion time is short, which is only suitable for acute tachycardia and without serious organic heart disease patients.Amiodarone onset is slower,but the cardioversion success rate is higher.

OBJECTIVE: To compare the acute toxicity of common injection and sustained-release preparation of norcantharidin for mice so as to identify the attenuation of the sustained-release preparation of norcantharidin. METHODS: The poloxamer 407 was used as a sustained-release vehicle for topical administration of norcantharidin, and the acute toxicity of mice treated with common injection and sustained-release preparation of norcantharidin was observed. The median lethal dose (LD(50)) was calculated by Bliss software. RESULTS: The symptoms of mice were similar between the two groups, but the appearance of symptoms in norcantharidin/poloxamer 407 group was 4 hours later than that in norcantharidin group. The LD(50) of norcantharidin administered through vein injection was 12.6 mg/kg. The LD(50) of norcantharidin/poloxamer 407 administered through intraperitoneal injection, intrahepatic injection and intramuscular injection were 19.9, 19.1 and 20.9 mg/kg, respectively, and the LD(50) of the common preparation were 13.0, 13.1 and 15.1 mg/kg, respectively. CONCLUSION: The norcantharidin/poloxamer 407 is less toxic than the equivalent dose of norcantharidin, mainly because norcantharidin/poloxamer 407 may release norcantharidin sustainedly, thus reducing norcantharidin concentration in blood.

OBJECTIVE: To establish a multidrug-resistant cell line BEL-7402/5-FU of hepatocellular carcinoma (HCC). METHODS: BEL-7402/5-FU was induced by pulse therapy combined with continuous stepwise exposure to 5-fluorouracil in vitro. MTT assay was used to determine its multidrug resistance (MDR). Biological characteristics of the BEL-7402/5-FU cell line were observed including morphological changes, cell growth curve, population doubling time, plate cloning efficiency, adherence rate, cell cycle distribution, chromosome and tumorigenicity. Accumulation amount of adriamycin (ADM) in cytoplasm was measured by flow cytometry. The protein expression of thymidylate synthase (TS) was evaluated by immuno-cytochemical method. RESULTS: The acquired MDR cell line of BEL-7402/5-FU was established successfully. The BEL-7402/5-FU cells showed cross-resistance to ADM, vincristine (VCR), methotrexate (MTX) and oxaliplatin (OHP), whereas still sensitive to hydroxycamptothecin (HCPT). The BEL-7402/5-FU cells tended to grow in clusters in vitro. It was found that the population doubling time of BEL-7402/5-FU cells was longer than that of its parental cells. The plate cloning efficiency and the adherence rate of BEL-7402/5-FU cells at the 2nd and 3rd hour were both lower than those of the parental cells. The distributing proportion of BEL-7402/5-FU cells in G(0)/G(1) phase was less than that of the parental cells, whereas the distributing proportion of BEL-7402/5-FU cells in S phase was higher than that of the parental cells. The accumulation amount of ADM in cytoplasm of BEL-7402/5-FU cells was significantly lower while the expression level of TS protein of which was highly up-regulated as compared with those of the parental cells. CONCLUSION: Establishment of the human HCC cell line BEL-7402/5-FU might be beneficial to the studies of 5-Fluorouracil acquired MDR mechanisms and the selection of reversal modifiers.

To examine the role of nitric oxide in the beta-adrenergic vasodilation of epicardial coronary arteries in dogs, 12 dogs were instrumented for measurement of left anterior descending coronary artery diameter by transthoracic echocardiography before and after dobutamine (5 microg/kg/min IV) with and without intracoronary infusion of NG-monomethyl-L-arginine (L-NMMA) (1 mg/kg). In all 12 dogs, the diameter of left anterior descending coronary artery increased significantly from 2.35 +/- 0.25 mm to 2.59 +/- 0.24 mm (P<0.001) after dobutamine administration. In 6 of the 12 dogs, the percent change in left anterior descending coronary artery diameter induced by dobutamine decreased significantly from 12.5% +/- 8.6% to -1.5% +/- 5.4% (P<0.05) after the administration of intracoronary L-NMMA (1 mg/kg for 5 min) to block nitric oxide synthesis from L-arginine. The study demonstrated that nitric oxide formation contributes to the beta-adrenergic dilatory response of epicardial coronary arteries to dobutamine in dogs.
Adrenergic beta-Agonists ; pharmacology ; Animals ; Coronary Vessels ; physiology ; Dobutamine ; pharmacology ; Dogs ; Echocardiography ; Female ; Male ; Nitric Oxide ; physiology ; Receptors, Adrenergic, beta ; physiology ; Vasodilation ; physiology ; omega-N-Methylarginine ; pharmacology

Objective To evaluate the safety of interventional radiotherapy with X-ray angiography. Methods To compare X-ray radiation levels with and without radioprotect with X-ray protective monitor by simulating operators' body's parts. Results The difference is significant. Conclusion Interventional radiotherapy with angiography with effective protect is safe.

Digital X-ray imaging technique has been developing rapidly in recent years, and makes it possible for people to be radiated by lower X-ray dose than before to get the images for diagnosis. Current development in 7 aspects about digital roentgenography is introduced in this article.