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Insomnia symptom is one of the most common types of sleep disturbances.Apart from being a risk factor for psychiatric disorders, insomnia symptom has been found to affect the course of psychiatric disorders and increase the relapse rate of psychiatric disorders.Therefore, insomnia treatment is beneficial to mitigate the psychiatric symptoms among chronic insomnia patients, which may help prevent mental health disorders.On the other hand, insomnia treatment for psychiatric patients is conductive to reduce the harm consequence in social function, which can help improving the prognosis of psychiatric disorders.Cognitive behavior therapy for insomnia (CBT-I) is a first-line treatment for chronic insomnia.This paper reviews the research progress on the efficiency of CBT-I on the psychiatric symptoms of chronic insomnia patients, as well as its application in comorbid psychiatric conditions.Findings from previous research suggested that CBT-I is effective to improve the psychiatric symptoms of insomnia patients through insomnia improvement, and it can also promote the remission of depression and anxiety symptoms, reduce the risk of substance disorder and suicide behaviors, and reduce the impairment of life quality and costs of treatment through insomnia improvement among psychiatric patients comorbid with insomnia, which indicated that CBT-I is a safe and effective treatment for insomnia symptoms in psychiatric patients.Moreover, this paper listed the contraindications and the decision-to-treat algorithm of CBT-I among psychiatric patients, as well as the CBT-I availability and adherence that limited the clinical application.More understanding of CBT-I is beneficial to provide support for a broad clinical application in mental health services.
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With the development of imaging technology, high-resolution magnetic resonance vascular wall imaging technology has been gradually applied to the risk assessment of intracranial aneurysms rupture. It has provided more comprehensive information for clinicians to assess the stability of intracranial aneurysms. This article summarizes the indicators used for assessing the risk of intracranial aneurysms rupture in recent years with high-resolution magnetic resonance vascular wall imaging.
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Objective@#To investigate the association between plasma selenium exposure and the risk of impaired glucose regulation (IGR).@*Methods@#A case-control study was conducted to select IGR patients who were admitted to the outpatient clinic of the Department of Endocrinology to perform oral glucose tolerance test(OGTT) at the Tongji Hospital affiliated to the Tongji Medical College from September 2004 to 2016 as a case group. Participants with normal glucose tolerance recruited from an unselected group of population undergoing routine health examinations in the same hospital were selected as a control group. The control group was matched according to the age (±5 years old) and sex of the case group. The inclusion criteria for subjects recruited were as follows: age ≥30 years, body mass index (BMI) <40 kg/m2, no history of a diagnosis of IGR or type 2 diabetes, and no history of receiving pharmacological treatment for hyperlipidemia or hypertension. Patients with any clinically systemic disease such as neurological or endocrine disease, acute illness, chronic inflammatory disease or infectious disease were excluded from the study. A total of 1 957 subjects, 897 in the case group and 1 060 in the control group, were included. Questionnaires were used to collect information of all subjects, and peripheral venous blood was collected after fasting and OGTT, respectively. Plasma selenium, fasting blood glucose, blood lipid (total cholesterol, triglycerides, high density lipoprotein cholesterol, and low density lipoprotein cholesterol) and 2 h OGTT plasma glucose concentration were detected, respectively. The subjects were divided into low, medium and high concentration groups according to the tertiles of plasma selenium concentration in the control group. The multivariate unconditional logistic regression analysis was performed to analyze the association between plasma selenium exposure and IGR.@*Results@#The age (mean±SD) of the case and control group was (53.71±11.38) and (53.95±12.17) years old. The plasma selenium concentration [M (P25, P75)] in the case group was 92.81(77.07, 107.05) μg/L, which was significantly higher than the control group [88.73 (77.13, 100.88) μg/L] (P<0.05). The results of multivariate unconditional logistic regression analysis showed that after adjusting for age, sex, BMI, family history of diabetes and hypertension, the risk of IGR was higher in the high-concentration group and the low-concentration group compared with the middle-concentration group, the values of OR (95%CI) were 1.22 (95%CI: 0.94-1.59) and 1.81 (95%CI: 1.42-2.30), respectively.@*Conclusion@#The study suggested a U-shaped association between plasma selenium and IGR.
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Objective:The aim of the current study is to understand the sleep disorders in children with autism and related factors.Methods:A case-control study method was conducted in this study which included 198 children autism who met the criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-Ⅳ) and 233 cases of gender-and age-matched normal children.Their general demographic and sleep data were collected and the children with autism were assessed with Autism Behavior Checklist,Child Behavior Checklist and Autism Spectrum Screening Questionnaire.Correlation analysis and regression analysis were performed to compare sleep quality,sleep problems and the related factors of the two groups.Results:The scores of difficulty falling asleep,sleep restlessness,taking hold or shaking,restless sleep,interrupted sleep,nightmares,sleepwalking,night terrors,sleep snoring,nocturnal enuresis,sleep apnea,mouth breathing,sweating and sleep scores were higher in the autism group compared to the normal control group before falling asleep (P ＜ 0.05),while the proportion of daytime sleep time in the autism group was lower than the normal control group (P ＜0.05).With sleep status as dependent variable,linear regression analysis was conducted with children's birth weight,walking month age,speaking month age,father age,and autism spectrum as independent variables.The multiple linear regression analysis showed the scores of,sensory behaviors,body and object use behaviors,and self-help behaviors in Autism Behavior Checklist for autistic children were positively associated with their sleep (β =0.21,0.21,0.29,P ＜ 0.05).However,paternal age at birth in the autism group had negative associatin with the sleep of autistic children (β =-0.16,P ＜0.05).In the autism group,their total scores of Autism Behavior Checklist and the scores of language and social behavior in Autism Behavior Checklist were not associated with their sleep status score (P ＞ 0.05).Conclusion:It suggests that children with autism may have more sleep problems,and their sleep problems are related to autism symptoms including the scores of,sensory behaviors,body and object use behaviors,and self-help behaviors in Autism Behavior Checklist for autistic and their paternal age at birth.
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Aim To explore the mechanism of E.coli heat-labile enterotoxin B subunit(LTB)as adjuvant by analysis of cellular proteins interacting with LTB. Methods Whole cell proteins were purified from RAW 264.7 cell after treated with LTB or NaCl 12 h, respectively.The cellular proteins were interacted with LTB and the interacting proteins were purified by pull-down assay and identified by mass spectrography.The LTB interaction proteins were conformed with Western blot and immunofluorescence assay.Results 25 LTB interaction proteins were found,and their interaction network was mapped;four proteins (Jup,Dsp,Ddx5 and Vimentin)were indicated to be related with LTB adjuvant activity;immunofluorescence assay indicated that GM130 interacted with LTB,however,Vimentin had no interaction with LTB in vivo.After treated by LTB,the expression of β-actin was upregulated obvi-ously in RAW 264.7 cell,whereras,Hspd1 did not show any change.Conclusions LTB exerts adjuvant activity through binding to GM1 of immune cells,cau-sing endocytosis and transporting to the Golgi apparatus by vesicles.Then LTB might bind to Jup and affect TCF/LEF activity,regulating the expression of Bcl 2, IL-6,and Runx3.The result is promoted T cell and B cell proliferation,differentiation and activation by se-cretion of cytokines and immunoglobulins.
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Objective To observe the effects of botulinum toxin A(BTX-A) injection combined with treadmill training on motor and gastrocnemius function in rats after spinal cord injury (SCI),so as to develop a possible treatment.Methods A total of 48 female Sprague-Dawley rats were randomly divided into four groups(n =12 in each):a control group which received normal saline injection(group Con-NS),an exercise group with normal saline injection(group Ex-NS),the other control group with BTX-A injection(group Con-BTX)and an exercise group which also received BTX-A injection(group Ex-BTX).All rats were subjected to incomplete SCI modelling using Allen's method.Each group then had l0 members left because of death or significant weight loss.After SCI modelling,BTX-A or normal saline were injected to rats' gastrocnemius,followed by weight support treadmill training(BWSTT) on days 7 through 35 days for the two exercise groups.Motor function was evaluated using inclined plane test before and 2 days,1,2,3,4 and 5 weeks after the injury.All rats were sacrificed 35 days after the surgery.Digit Abduction Scoring(DAS) and electrophysiological testing were performed prior to sacrifice,and the general form and the wet weight of gastrocnemius were observed after resection.Results No significant differences in the inclined plane angle among 4 groups were detected before injury and 2 days afterward (P ＞ 0.05).At the 2nd-Sth week,however,the inclined plane angles in group Ex-NS were significantly higher than those in group Con-NS (P ＜ 0.05).Those of group Ex-NS were also significantly higher than group Ex-BTX 2-5 weeks after injury (P ＜ 0.05).No significant differences were detected between group Con-BTX and group Ex-BTX,as well as group Con-NS and group Ex-BTX at each time point (P ＞ 0.05).And the average DAS score in group Con-BTX and group Ex-BTX was 0,while that of Con-NS group and group Ex-NS were both 4.There were no significant differences between the two normal saline injection groups (P ＜ 0.05),nor between the two BTX-A injection groups (P ＜ 0.05).However,the average DAS scores in the Con-BTX and Ex-BTX groups were significantly higher than the Con-NS and Ex-NS groups (P ＜ 0.05).No significant atrophy of gastrocnemius muscles were observed in the Con-NS group or Ex-NS group,and as would be expected,the muscles in group Ex-NS were thicker on average than those in group Con-NS.Significant atrophy was observed in group Con-BTX and group Ex-BTX.Moreover,the muscle wet weight was significantly higher in group ExNS than group Con-NS (P ＜ 0.05).Compared with group Con-NS and group Ex-NS,the muscle wet weight was significantly lower in group Con-BTX and group Ex-BTX (P ＜ 0.05).No significant differences in the latency of the compound muscle action potential (CAMP) were detected among 4 groups (P ＞0.05),but the CAMP amplitude was significantly less in the control groups than in the exercise groups.(P ＜0.05).Conclusions Exercise training can significantly improve motor and skeletal muscle function in SCI rats,but BTX-A injection can inhibit the improvement.
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Objective To characterize 15 months later the quality of life (QOL) and depression of those with spinal cord injury (SCI) suffered during the Wenchuan earthquake,and to identify the influence factors.MethodsA sample of 27 individuals who sustained SCI during the Wenchuan earthquake were surveyed using face- to-face interviews.QOL was measured using the brief version of the World Health Organization's Quality of Life Assessment instrument.Depression was measured using the patient health questionnaire depression module 9.Stepwise multiple linear regression was employed to determine the factors most closely related with QOL and depression. ResultsStepwise linear regression showed a significant correlation of overall QOL with literacy and age.The younger or illiterate victims showed a lower overall QOL.General health was also associated with ability in the activities of daily living and with pain.Victims with better daily ability and less pain may have had better general health.Depression correlated with literacy and secondary condition.Illiterate patients or patients influenced more by a secondary condition displayed more serious depression than the others.Additionally,social participation was significantly associated with the physical health,psychological health and social relationships domains of QOL.ConclusionThe QOL of long-term SCI victims caused by the earthquake is closely related to age,literacy,pain,participation and physical independence.Depression is associated with illiteracy and secondary conditions.Attention should be paid to these correlations in designing long-term rehabilitation strategies.
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Objective To analyze factors contributing to the quality of life of earthquake victims with nonunion fracture in limbs after medical rehabilitation and to provide a clinical reference for future disasters.Methods Thirty-one wounded who sustained their injuries in the Sichuan earthquake completed the short form-36(SF-36)questionnaire 2 weeks before their amputation,and after 3,6 and 12 months of medical rehabilitation.The SF-36scores were compared with Sichuan population norms.Stepwise multiple linear regression was used to highlight variables which influenced their functional recovery and their physical and mental health.Results The physical and mental health composite scores of the 31 victims were significantly lower than Sichuan population norms before medical rehabilitation,but they had a significant increasing trend after 3,6 and 12 months of treatment.Their scores on all the domains remained significantly lower than Sichuan population norms at a later follow-up.Smoking,external fixations and chronic diseases were related to their recovery of physical function.Age,permanent housing,family income and casualties among family members were related to their mental health recovery.Conclusion The quality of life of patients with nonunion fracture caused by earthquake can be improved significantly through medical rehabilitation.But social factors should be considered in addition to medical rehabilitation after an earthquake.
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Objective To analyze the outcomes of clinical management and rehabilitation interventions for earthquake victims with spinal cord injury. Methods Comprehensive rehabilitation intervention was conducted for 3 to 4 months with 51 earthquake victims with spinal cord injuries. The study involved their physical examination and on site interviews during hospitalization, and follow-up by telephone. Etiology, severity, complications and outcomes of rehabilitation and clinical management were analyzed. Results In 9.8% of the patients the spinal cord injury was at C7 or above, 5.9% at C8 to T6 , 68.6% at T7 to L2 , 13.7% at L3 to S2 and 2.0% at S2 or below. There were 22 complete injuries and 29 incomplete. After 4 months of training, 76.5% of the wounded reached wheelchair independence, 78.4% ambulated with an orthosis and 88.2% were partially independent in the activities of daily living.Conclusions The comprehensive rehabilitation intervention allowed most of the victims to resume an independent life. Their long-term care remains a challenge.
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Objective To study the location of mycobacterium tuberculosis(MTB) and whether the cellular immunity is induced after immunization of H37Ra in mice.Methods Totally 72 BALB/C mice were included.Thirty mice were intracutaneously injected of 0.1 ml H37Ra solution(about 10~(6) bacteria) at caudal region;thirty mice were injected of BCG of same quantity instead;twelve were free from immunization as control.Viable MTB were detected in spleen and lungs on day 15,30 and 60 after intracutaneous vaccination of H37Ra.The proliferation of T lymphocytes stimulated with purified protein derivative(PPD) was measured by MTT assay and the production of interleukin-2(IL-2) and soluble interleukin-2 receptor(sIL-2R) in the cultural supernatants of T lymphocytes was also determined by ELISA on day 30 and 60 after intracutaneous vaccination of H37Ra.Results Viable H37Ra or BCG could be located in the spleen and lungs in mice for at least 60 d.After H37Ra immunization,the stimulation index(SI) of T lymphocyte proliferation on day 30 and 60 was(2.81?0.63),(2.16?0.52) respectively,which was of no significant difference with that of BCG immunization,but of significant difference with that of non-immunized mice(P