The effect of sirolimus-based immunosuppression vs. conventional prophylaxis therapy on cytomegalovirus infection after liver transplantation.

OBJECTIVE: The aim of this study was to assess the efficacy of sirolimus-based immunosuppression vs. conventional prophylaxis therapy in preventing cytomegalovirus (CMV) infection or disease in liver transplantation recipients. METHODS: One hundred and twenty-seven consecutive liver transplant recipients, with a minimum of one-yr follow-up from 2008 to 2013 in the first affiliated hospital of Nanchang University, were retrospectively divided into the sirolimus-treated (n = 51) and ganciclovir-treated (n = 76) groups. The CMV incidence, rejection events, and survival rate were compared. RESULTS: The overall incidences of CMV events were decreased but did not reach statistical significance in the sirolimus arm compared with the ganciclovir arm (p > 0.05) at one yr after liver transplantation. There was no significant difference in the rejection incidence and survival rates between the two groups. CONCLUSIONS: Sirolimus-based immunosuppression had a lower incidence of CMV infection compared with conventional prophylaxis therapy and did not increase rejection risks and mortality after liver transplantation, indicating that with the use of an mammalian target-of-rapamycin (mTOR)-inhibitor, CMV prophylaxis may be dispensable.

A survey of sleep quality in patients with 13 types of mental disorders.

OBJECTIVE: To investigate the sleep characteristics of a community sample of patients with 13 types of mental disorders. METHOD: Subjects aged 18 years and older were sampled from the Epidemiologic Sites Survey of Mental Illness at a mental health center in Hebei Province, Baoding, China, from October 2004 to March 2005. The study group included 1,874 subjects who met the diagnostic criteria of 13 types of mental disorders according to the Structured Clinical Interview for DSM-IV-TR Axis I Disorders-Patient Edition (major depressive disorder, panic disorder, generalized anxiety disorder, posttraumatic stress disorder, dysthymic disorder, bipolar affective disorder, somatoform disorder, obsessive-compulsive disorder, specific phobia, schizophrenia, adjustment disorder, social phobia, and alcohol abuse and dependence.) The control group included 15,117 subjects without mental disorders. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality, and the Global Assessment of Functioning (GAF) was used to assess social life function. RESULTS: The prevalence of sleep disorders was 11.6% in the survey respondents. The prevalence of sleep disturbances in the group with 13 types of mental disorders ranged from 19.30% to 69.92%. There was a significant difference in the prevalence of sleep disorders between the study group (48.61%) and the control group (5.55%; P < .01). The prevalence of sleep disturbance in subjects with major depressive disorder and generalized anxiety disorder was 69.92% and 58.27%, respectively. Longer sleep latency and shorter sleep duration were the most common features of low quality sleep in patients with mental disorders. There was a significant difference in sleep latency and duration in subjects with major depressive disorder (P < .01), dysthymic disorder (P < .01), and generalized anxiety disorder (P < .01) compared to control subjects. Sleep medication was used most by subjects with schizophrenia and least by those with social phobia. Daytime dysfunction was most notable in subjects with major depressive disorder. Subjects with mental disorders with sleep disorders tended to be older than those with mental disorders without sleep disorders. The prevalence of sleep disorders was higher in patients with mental disorders who were female, older, less educated, retired or farmers, and widowed. There was no relation between the severity of depression and sleep disorders. CONCLUSIONS: The prevalence of sleep disorders in subjects with mental disorders was high. Longer sleep latency and shorter sleep duration were the most common characteristics of low quality sleep in the patients with mental disorders and were most notable in those with depression.

The Posterior Contour Sign of the Lumbar Intervertebral Disc----A Sign to Show the Posterior Border of Disc in Plain Film / 实用放射学杂志

Objective:To eveluate and study the anatomic basis of the posterior contour sign of lumbar intervertebral disc.Methods:The most protruding length of the soft tissue mass behind intervertebral spase on lumbar plain film were measured in 100 cases and compared with CT or MR findings.Results:41 posterior contour sign of the interlumbar disc were fined in 39 cases,of which there were 25 in L4/5(61.0%),15 in L3/4(15.6%)and 1 in L2/3(2.4%).The protruding was less than 0.2 cm in 26 and larger than 0.2 cm in 15,there were 10 lumbar disc protruding confirmed by CT or MR ,7 of which the pesterior contour ≥0.2 cm,and 3＞0.3 cm,none was ≤0.2 cm.Conclusion:The adipose tissue in the posterior border of lumbar body and disc was the anatomic basis of the sign,and it was an importent sign for diagnosing of lumbar disc hernia on plain film.