Acute sleep deprivation exacerbates systemic inflammation and psychiatry disorders through gut microbiota dysbiosis and disruption of circadian rhythms.

Acute sleep deprivation (ASD) is often observed in shift workers and characterized by drowsiness and unrelenting exhaustion. The physiological and psychological effects of ASD include anxiety, depression, cognitive impairment, systemic inflammation, stress responses, and disruptions of gut microbiota. However, the mechanisms involved in the ASD-associated circadian dysregulations with regard to gut dysbiosis, systemic inflammation, physiological modulation, and psychiatry disorders remain unclear. The aim of this study was to investigate whether central nervous system disorders induced by ASD are related to inflammation, barrier dysfunction, and circadian dysregulation. We also assessed impacts on microbiota succession. Male C57BL/6 mice were randomly allocated to the control and sleep deprivation (SD) groups. Mice in the SD group were subjected to 72 h of paradoxical SD using the modified multiple-platform method for ASD induction (72 h rapid eye movement-SD). The effects of ASD on dietary consumption, behaviors, cytokines, microbiota, and functional genes were determined. The appetite of the SD group was significantly higher than that of the control group, but the body weight was significantly lower than that of the control group. The anxiety-like behaviors were found in the SD group. Alpha and beta diversity of microbiota showed significant decrease after ASD induction; the relative abundance of Candidatus_Arthromitus and Enterobacter was increased, whereas that abundance of Lactobacillus, Muribaculum, Monoglobus, Parasutterella, and others was decreased in the SD group. These effects were accompanied by reduction in fecal propionic acid. In the proximal colon, the SD group exhibited significantly higher inflammation (tumor necrosis factor-α [TNF-α]) and dysregulation of the circadian rhythms (brain and muscle ARNT-like 1 [BMAL1] and cryptochrome circadian regulator 1 [CRY1]) and tight junction genes (occludin [OCLN]) than the control group. Gut barrier dysfunction slightly increased the plasma concentration of lipopolysaccharide and significantly elevated TNF-α. Inflammatory signals might be transduced through the brain via TNF receptor superfamily member 1 A (TNFRSF1A), which significantly increased the levels of microglia activation marker (ionized calcium-binding adapter molecule 1 [IBA1]) and chemokine (intercellular adhesion molecule 1 [ICAM1]) in the cerebral cortex. The serotonin receptor (5-hydroxytryptamine 1A receptor [5-HT1AR]) was significantly downregulated in the hippocampus. In summary, 72 h of rapid eye movement-SD induced physiological and psychological stress, which led to disruption of the circadian rhythms and gut microbiota dysbiosis; these effects were related to decrement of short chain fatty acids, gut inflammation, and hyperpermeability. The microbiota may be utilized as preventive and therapeutic strategies for ASD from the perspectives of medicine and nutrition.

Risk stratification of 2- to 5-cm gastric stromal tumors based on clinical and computed tomography manifestations.

OBJECTIVE: To evaluate the risk stratification of 2- to 5-cm gastric stromal tumors (GSTs) by analyzing their clinical and computed tomography (CT) manifestations with the goal of providing imaging evidence for rational selection of surgical methods. METHODS: This study involved 223 patients with pathologically diagnosed GSTs of 2 to 5 cm in diameter. According to the pathological results and malignant risk category, the patients were divided into a low-risk biological behavior group (very low and low risk) and high-risk biological behavior group (intermediate and high risk). The clinical and CT manifestations were compared between the groups. The chi-square test was used to analyze categorical variables, and the independent-samples t test was used to analyze continuous variables. Multivariate logistic regression and receiver operating characteristic curve analysis were performed for statistically significant variables. RESULTS: The tumor contour, necrosis, surface ulceration, and long diameter were significantly different between the low-risk group and the high-risk group (P < 0.05). Multivariate logistic regression analysis showed that the tumor contour and long diameter were independent risk factors. The area under the curve was 0.82, and the accuracy, sensitivity, and specificity were 0.78, 77.4 %, and 79.7 %, respectively. CONCLUSIONS: The risk associated with 2- to 5-cm GSTs can be preoperatively predicted in an indirect manner through analysis of clinical and CT manifestations, and this model has high diagnostic value.

Characterization of Clinical and CT Manifestations of Pulmonary Cryptococcosis with Consolidation.

Considering the insufficient understanding of pulmonary cryptococcosis (PC) with consolidation, 22 patients were evaluated based on the chest computed tomography (CT) images and clinical manifestation. The clinical symptoms were mild, mainly manifesting as cough and sputum. Pulmonary lesions mostly involved a single lobe in a single lung with multiple lesions. Specifically, single lung involvement was observed in 17 cases, single lobe in 16 cases and multiple lesions in 14 case. Fifteen cases were mainly distributed in the periphery and 17 cases in the long axis in parallel to the pleura. Nineteen cases had air bronchograms. Eight cases displayed cavitation inside the lesions and 18 cases had surrounding halo signs. Seventeen cases had pleural thickening, of which 10 cases had "pasting wall" signs. The clinical symptoms of PC with consolidation were relatively mild. Comprehensive clinical and imaging performance could improve the diagnosis of the disease.

Characteristics of diffusion tensor imaging of central nervous system in children with tourette's disease.

To investigate the characteristics of diffusion tensor imaging (DTI) of the central nervous system in children with Tourette syndrome (TS).Fifteen children with TS (TS group) and 15 normal children (control group) were studied, and all of them underwent DTI. The apparent diffusion coefficient (ADC) and fractional anisotropy (FA) parameters were calculated using the DTIStudio software. The region of interest was delineated manually. The ADC and FA values of the bilateral caudate nucleus, bilateral globus pallidus, bilateral putamen, bilateral thalamus, and bilateral frontal lobe white matter were measured using the region of interest editor software. The differences of FA values and ADC values between the same brain areas were compared. The associations between ADC, FA values and Yale Global Tic Severity Scale (YGTSS) scores were evaluated by Pearson correlation analyses.The FA values of left globus pallidus and left thalamus were significantly lower in the TS group than in the control group (P < .05), while the ADC values of the right caudate nucleus and bilateral thalamus were significantly higher in the TS group than in the control group (P < .05). The decrease in FA in the left thalamus significantly correlated with the YGTSS score (r = 0.692; P < .05). No correlation was found between FA and ADC values in other brain regions and the YGTSS score (P > .05).After the DTI analyses, abnormalities were found in the left globus pallidus, right caudate nucleus, and bilateral thalamus in children with TS. Especially the changes in the left thalamus structure was crucial in the pathophysiological clock of TS.

Sleep deprivation reduces the recovery of muscle injury induced by high-intensity exercise in a mouse model.

Sleep is crucial to improve athlete performance and their circadian rhythm, but sleep patterns may be disturbed because athletes participate in several competitions. In addition, intensive training programs can cause muscle pain and psychological stress in athletes, resulting in a lack of sleep. Sleep also plays a critical role in the recovery of muscle injury induced by exercise. The current study evaluated the effect of sleep deprivation on the recovery of muscle injury induced by high-intensity exercise in a mouse model. In this study, 28 mice were randomly assigned to four groups (N = 7): control (Control), exercise (EX), sleep deprivation (SD), and sleep deprivation with exercise (EX+SD). The mice from the EX and EX+SD groups were subjected to high-intensity swimming. The results showed that 72-h sleep deprivation increased food intake and reduced body weight. However, the manipulation of 8-week exercise and/or 72-h sleep deprivation did not have any effect in the elevated plus maze task and tail suspension test. Interestingly, the EX+SD group exhibited improved memory performance in the Morris water maze and impaired motor activity in the open field test. According to the TNF-α level and aspartate aminotransferase (AST), and creatine phosphokinase (CK) activities, only the EX+SD group exhibited muscle impairment. Overall, high-intensity exercise may cause muscle injury, and adequate sleep can recover muscle damage. However, sleep deprivation reduces protein synthesis, which decreases the ability to restore muscle damage and aggravates the harmful effect of high-intensity exercise.

Preoperative evaluation of neurovascular relationship in trigeminal neuralgia by three-dimensional fast low angle shot (3D-FLASH) and three-dimensional constructive interference in steady-state (3D-CISS) MRI sequence.

OBJECTIVE: The purpose of the study was to evaluate the value of high-resolution three-dimensional fast low angle shot (3D-FLASH) and three-dimensional constructive interference in steady-state (3D-CISS) MRI sequence solely or the combination of both in the visualization of neurovascular relationship in patients with trigeminal neuralgia (TN). METHODS: 65 patients with unilateral TN underwent 3D-FLASH and 3D-CISS imaging were retrospectively studied. Neurovascular relationship at the intracisternal segment of trigeminal nerve was reviewed by two experienced neuroradiologist, who was blinded to the clinical details. The imaging results were compared with the operative findings in all patients. RESULTS: The accuracy and positive rates of the 3D-FLASH + CISS imaging (98.46, 92.31%) in judging the symptomatic side according to the presence of vascular contacts were higher than those of 3D-CISS (90.77%, 84.62) or 3D-FLASH (89.23, 83.08%) sequence. In addition, the statistical analysis showed the sensitivity and accuracy of 3D-FLASH + CISS imaging was higher than that of 3D-FLASH (p < 0.05). The 3D-FLASH + CISS imaging was more accurate in determining the type of offending vessel than 3D-CISS or 3D-FLASH imaging. CONCLUSION: The retrospective study demonstrates that the combination of 3D-FLASH with 3D-CISS sequence well delineates the relationship between intracisternal segment of trigeminal nerve and adjacent vessels in terms of increased positive rates and accuracy. Advances in knowledge: The study firstly dealt with the combination of 3D-CISS and 3D-FLASH imaging in TN.