Efficacy and Safety of Pulse Magnetic Therapy System in Insomnia Disorder: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial

Objective@#This study’s objective is to assess the efficacy and safety of Pulsed Magnetic Therapy System (PMTS) in improving insomnia disorder. @*Methods@#Participants with insomnia disorder were randomly assigned to receive either PMTS or sham treatment for four weeks (n= 153; PMTS: 76, sham: 77). Primary outcomes are the Insomnia Severity Index (ISI) scores at week 0 (baseline), 1, 2, 3, 4 (treatment), and 5 (follow-up). Secondary outcomes are the Pittsburgh Sleep Quality Index at baseline and week 4, and weekly sleep diary-derived values for sleep latency, sleep efficiency, real sleep time, waking after sleep onset, and sleep duration. @*Results@#The ISI scores of the PMTS group and the sham group were 7.13±0.50, 11.07±0.51 at week 4, respectively. There was a significant group×time interaction for ISI (F3.214, 485.271=24.25, p<0.001, ηp 2=0.138). Only the PMTS group experienced continuous improvement throughout the study; in contrast, the sham group only experienced a modest improvement after the first week of therapy. At the end of the treatment and one week after it, the response of the PMTS group were 69.7% (95% confidence interval [CI]: 58.6%–79.0%), 75.0% (95% CI: 64.1%–83.4%), respectively, which were higher than the response of the sham group (p<0.001). For each of the secondary outcomes, similar group×time interactions were discovered. The effects of the treatment persisted for at least a week. @*Conclusion@#PMTS is safe and effective in improving insomnia disorders.

Finite Element Analysis on Sanders II and III Calcaneal Fractures Treated with the Novel Composite Locking Plate / 医用生物力学

Objective To study the stress distribution and biomechanical stability of the long-type composite locking plate already used in clinic practice and the novel short-type composite locking plate for treating Sanders type IIa, IIb and IIIab calcaneal fractures. Methods The three-dimensional (3D) models of Sanders type IIa, IIb and IIIab calcaneal fractures were established, and the force conditions of calcaneus in neutral standing position and under 20°dorsal extension were simulated. By referring to the physical form of human specimens, 500 N vertical axial load was applied, so as to study the displacement and relative displacement of the fracture block under the force, and the force conditions of bone tissues and internal fixation were analyzed. Results For Sanders type IIa, IIb calcaneal fractures treated with long-type and short-type composite locking plates, the stress concentration positions of the plates and calcaneal fractures were basically the same. The maximum stress difference of the two plates for fixing calcaneal fractures with the same type was smaller than 5 MPa, and there was no significant difference in the maximum displacement of the fracture models. For Sanders type IIIab calcaneal fractures treated with long-type and short-type composite locking plates, the maximum stress concentration occurred in the forearm of plate screws, indicating the risk of metal fatigue. The maximum stress difference was up to 12 MPa, and the maximum calcaneal displacement was up to 9 μm. Conclusions The long-type and short-type composite locking plates showed no significant differences in treating Sanders type IIa, IIb calcaneal fractures. For fixing Sanders type IIIab calcaneal fractures, the long-type composite locking plate was superior to the short-type composite locking plate.

Neural Signature for Auditory Hallucinations in Schizophrenia: A High-Resolution Positron Emission Tomography Study with Fludeoxyglucose (¹⁸F)

OBJECTIVE: Auditory hallucinations (AHs) are a core symptom of schizophrenia. We investigated the neural signature of AHs by comparing hallucinating patients with schizophrenia with non-hallucinating patients with schizophrenia. METHODS: We recruited hallucinating patients with schizophrenia meeting the criteria for persistent, prominent, and predominant AHs (n=10) and non-hallucinating patients with schizophrenia (n=12). Various clinical assessments were performed incluing Psychotic Symptom Rating Scale for Auditory Hallucinations. Using fludeoxyglucose (¹⁸F) positron emission tomography, regional differences in neural activity between the groups were analyzed. RESULTS: The regions of interest analysis showed significantly lower standardized uptake value ratio (SUVR) in the superior, middle, and inferior frontal gyri, and higher SUVR in the putamen in patients with AHs versus patients without AHs. These findings were confirmed in the voxel-wise analysis. CONCLUSION: Our findings indicate that hypoactivity in the frontal and cingulate gyri, coupled with hyperactivity in the temporal gyrus and putamen, may contribute to the pathophysiology of AHs.

Three-dimensional reconstruction of pelvic CT in guiding iliac nail implantation / 中国组织工程研究

BACKGROUND: Iliac screw implantation has no unified standard. Because of the large individual differences, preoperative pelvic three-dimensional (3D) CT reconstruction can measure the diameter, depth and angle of the screws, which increases the placement accuracy. OBJECTIVE: To measure the screw placement-related data by pelvic 3D CT reconstruction, so as to guide the screw placement and improve its accuracy. METHODS: Fifty patients with pelvic lesions or fractures admitted in Shandong Provincial Third Hospital from January 2013 to December 2016 were selected, and the pelvis was scanned with CT and then was reconstructed. The point A (the intersection of S1posterior sacral posterior wall and posterior superior iliac spine) was as the screw placement point, and three paths were measured on the point: posterior superior iliac spine path (AD path); anterior inferior iliac spine path (AC path); top of greater sciatic notch to the acetabular roof (AB path). On the plane of these three pathes, the section was made on the iliac bone, respectively; in each section, the channel for iliac nail was designed. RESULTS AND CONCLUSION: (1) In the same path, there was no significant difference in the path length of the screw between male and female patients (P > 0.05). Paired t test showed that the diameter and length depth and angle of the screws were significantly different between AD and AC paths, AC and AD (P < 0.05). (2) There was no significant difference in the inclination angle of the spiral channel between male and female patients (P > 0.05). The inclination angle of the spiral channel and lateral angle at different paths showed significant difference between male and female patients (P < 0.05). (3) To conclude, 3D reconstruction of pelvis CT can be used to measure the length, diameter and angle of the iliac screw, and to guide the surgical treatment.

Longer Telomere Length of T lymphocytes in Patients with Early and Chronic Psychosis

OBJECTIVE: To investigate pathological conditions that act as sources of pro-inflammatory cytokines and cytotoxic substances to examine telomere length (TL) in patients with either early (duration of illness [DI] ≤5 years) or chronic (DI >5 years) psychosis using T lymphocytes. METHODS: Based on these factors and the important role that T lymphocytes play in inflammation, the present study measured the TL of T lymphocytes in patients with either early or chronic psychosis. Additionally, smoking, metabolic syndrome, depression, and cognitive functioning were assessed to control for confounding effects. RESULTS: TL was significantly longer in patients with early and chronic psychosis than in healthy control subjects and, moreover, the significance of these findings remained after controlling for age, smoking, metabolic syndrome, DI, chlorpromazine-equivalent dose, and cognitive functioning (F=9.57, degree of freedom=2, p<0.001). Additionally, the DI, chlorpromazine-equivalent doses, and the five-factor scores of the Positive and Negative Syndrome Scale were not significantly correlated with the TL of T lymphocytes in either all patients or each psychosis group. CONCLUSION: Possible mechanisms underlying the effects of antipsychotic medications on telomerase are discussed in the present study, but further studies measuring both telomerase activity and TL using a prospective design will be required.

Effect of GLYX-13 on cognitive function after long-time isoflurane anesthesia in mice / 中华麻醉学杂志

Objective To evaluate the effects of GLYX-13 on cognitive function after long-time isoflurane anesthesia in mice. Methods A total of 192 healthy male C57∕B6J mice, aged 8 weeks, weig-hing 22-25 g, were divided into 4 groups(n=48 each)using a random number table: control group (group C), isoflurane anesthesia group(group I), GLYX-13 group(group G), and isoflurane anesthesia plus GLYX-13 group(group IG). The animals were exposed to 15% isoflurane for 6 h in I and IG groups. GLYX-13 1 mg∕kg was injected via the caudal vein at 2 h before anesthesia in G and IG groups. Novel ob-ject recognition test and contextual fear conditioning test were performed on 1st, 3rd and 7th days after an-esthesia. The expression of 2B subunits-containing NMDA receptor(NR2B)and cyclic adenosine mono-phosphate response element-binding protein(CREB)mRNA in the hippocampus was detected by quantita-tive real-time polymerase chain reaction after the end of behavioral tests on 1st, 3rd and 7th days after anes-thesia. Results Compared with group C, the percentage of time spent in exploring a novel object, dis-crimination index and percentage of freezing time were significantly decreased, and the expression of NR2B and CREB mRNA in the hippocampus was down-regulated in group I(P <005). Compared with group I, the percentage of time spent in exploring a novel object, discrimination index and percentage of freezing time were significantly increased, and the expression of NR2B and CREB mRNA in the hippocampus was up-regulated in group IG(P <005). Conclusion GLYX-13 can significantly improve the cognitive func-tion after long-time isoflurane anesthesia in mice.

Bilateral Repetitive Transcranial Magnetic Stimulation for Auditory Hallucinations in Patients with Schizophrenia: A Randomized Controlled, Cross-over Study

OBJECTIVE: A randomized double-blind cross-over trial was conducted in patients with persistent auditory hallucinations (AHs) to investigate whether bilateral repetitive transcranial magnetic stimulation (rTMS) at the temporoparietal area or Broca's area is more effective at high- or low-frequencies compared to a sham condition. METHODS: Twenty three patients with persistent AHs who remained stable on the same medication for 2 months were enrolled. They were randomized to one of four conditions: low-frequency (1 Hz)-rTMS to the temporoparietal area (L-TP), high-frequency (20 Hz)-rTMS to the temporoparietal area (H-TP), high-frequency (20 Hz)-rTMS to Broca's area (H-B), or sham. RESULTS: All the four rTMS conditions resulted in significant decrease in the scores under the auditory hallucination rating scale and hallucination change scale over time. However, there were no significant treatment effects or interaction between time and treatment, suggesting no superior effects of the new paradigms over the sham condition. CONCLUSION: Our findings suggest that bilateral rTMS at the temporoparietal area or Broca's area with high- or low-frequency does not produce superior effects in reducing AHs compared to sham stimulation.

Changes in expression of hepatic circadian clock gene in different types of circadian rhythm and effect of isoflurane anesthesia on expression of hepatic circadian clock gene in mice / 中华麻醉学杂志

Objective To investigate the changes in the expression of hepatic circadian clock gene in different types of circadian rhythm and the effect of isoflurane anesthesia on the expression of hepatic circadian clwk gene in mice.Methods Seventy-two male C57/B6 mice,aged 2 months,weighing 20-25 g,were randomly divided into 3 groups (n =24 each):normal light/dark (LD) cycle group,reversal LD cycle group and anesthesia group.Normal LD cycle group and anesthesia groupwere maintained in a regular 12 h LD cycle with lights on at 8:00 am and off at 8:00 pm for 3 weeks,and in addition anesthesia was then performed with isoflurane in anesthesia group.Reversal LD cycle group was kept in an inverted12 h LD cycle with lights on at 8:00 pm and off at 8:00 am for 3 weeks.The natural time was converted to circadian time (CT) and the initial time was set at CT0.Isoflurane anesthesia group was exposed to 2％ isoflurane for 6 h during the wakening period from CT14 to CT20.The liver and suprachiasmatic nucleus (SCN) were removed from mice at CT2,CT8,CT14 and CT20 for determination of Clock and Cry1 mRNA expression by real-time quantitative PCR.Results Clock and Cry1 mRNA expression in the liver and SCN showed rhythm in the two different types of circadian rhythm.Compared with that in SCN,the peak phase of Clock and Cry1 mRNA expression in livers was delayed in two different types of circadian rhythm.Isoflurane anesthesia caused a peak phase delay of Cry1 and Clock mRNA expression in livers as compared with normal LD cycle group.Conclusion Circadian clock gene in livers shows rhythmic expression in different types of circadian rhythm,and isoflurane anesthesia can cause a large peak phase delay of circadian clock gene expression in livers of mice.

Effects of resveratrol on spatial memory ability in chronic constriction injury of sciatic nerve mice / 中华行为医学与脑科学杂志

Objective To investigate spatial memory ability of intraperitoneal injection of resveratrol in a mice model of chronic constriction injury of sciatic nerve(CCI).Methods Forty-four C57BL/6 mice were divided randomly into 4 groups:sham group (n=14),CCI group (n=14),resveratrol pre-treatment group (i.p.resveratrol 100 mg/kg 30 minutes before CCI model,n=8) and resveratrol post-treatment group (i.p.resveratrol 100 mg/kg 14 days after CCI model,n =8).CCI group,resveratrol pre-treatment group and resveratrol post-treatment group were operated with the model of neuropathic pain induced by chronic constriction injury of sciatic nerve.In shamoperated controls,an identical surgical procedure was performed,except that the sciatic nerve was not ligated.This was accomplished by using intellicage for mice by newbehavior to record their spatial memory after surgery.Results (l) Resveratrol pre-treatment group showed improved spatial memory ability compared with sham group and CCI group during day 17-21 (17 d:(55.80±7.66) ％,(51.20±7.94) ％ ; 18 d:(60.20±3.89) ％,(49.80±8.61) ％ ; 19 d:(62.20±7.25) ％,(51.20±6.83) ％ ;20 d:(63.00±9.69) ％,(48.40±8.84) ％ ;21 d:(56.80±7.52) ％,(47.20±4.54) ％)(P＜0.05),compared with CCI group.(2)From day 26,the spatial memory damage was observed in mice with CCI (26 d:(37.50±5.50)％,(51.80±9.01)％;27 d:(37.25±4.19)％,(51.20±5.76)％;28 d:(42.25± 3.50) ％,(52.80± 7.52) ％) (P＜ 0.05),compared with sham group.And this damage could be reversed by resveratrol,which was injected when the chronic pain was stable (26 d (46.60± 5.27) ％,27 d (54.00± 7.31) ％,28 d (52.60±4.39)％),compared with CCI group(P＜0.05).Conclusion Chronic constriction injury of sciatic nerve mice due to spatial memory impairment can be improved by resveratrol.

Effects of special CaMKⅡ inhibitor m-AIP on sensory-discriminative and affective-motivational pain responses in chronic constriction injury of sciatic nerve rats / 中华行为医学与脑科学杂志

Objective To investigate the sensory-discriminative and affective-motivational pain response of intrathecal injection of m-AIP,a special inhibitor of CaMKII,in a rat model of chronic constriction injury of sciatic nerve(CCI).Methods Eighteen SD rats were divided randomly into 3 groups(n=6):Group S(sham),Group C(control) and Group m-AIP.Group C and m-AIP were operated with the model of neumpathic pain induced by chronic constriction injury of sciatic nerve; Group S were treated as sham operated rats.Seven days after operation,Group S and C received intrathecal injection of 0.9％ NaCI 20 μl,while Group m-AIP received intrathecal injection of m-AIP 0.5 nmol/20 μl.Escape/avoidance behavior refrecting the affective-motivational dimension of pain was measured on 1.5 h after administration.Rats received pain behavior tests including paw withdrawal mechanical threshold(PWMT) and paw withdrawal thermal latency(PWTL) before and 2 h,4 h,8 h after administration.Results Treatment with m-AIP attenuated escape/avoidance behavior and reversed pain behaviors after CCI.At 2h and 4h after administration,Group m-AIP PWTL((1 1.45 ± 2.04)s,(10.26 ± 1.48)s) and PWMT ((21.15 ±4.32)g,(20.45 ±4.09) g) were increased when compared with Group C PWTL((9.63 ± 1.65)s,(9.30 ±0.73)s),PWMT((13.87 ±2.36)g,(14.80 ±3.12)g)(P＜0.05).Before and8 h after administration,Group m-AIP PWTL,PWMT had no significant difference when compared with Group C (P ＞ 0.05).Conclusion CaMKⅡ may play an important role in sensory and affective pain processing in neuropathic rats.Intrathecal injection of m-AIP can effectively improve pain behaviors and attenuate negative affect.