Objective:Drug-induced sleep endoscopy(DISE)allows for the evaluation of dynamic airway collapse in patients with obstructive sleep apnea.However,a standardized sedation regimen for DISE is not yet available.This stud...Objective:Drug-induced sleep endoscopy(DISE)allows for the evaluation of dynamic airway collapse in patients with obstructive sleep apnea.However,a standardized sedation regimen for DISE is not yet available.This study aimed to investigate the safety profiles and efficacies of dexmedetomidine combined with butorphanol for DISE.Methods:Sixty patients with obstructive sleep apnea scheduled to undergo DISE were randomly divided into Group D and Group DB.All recipients were initially given intravenous butorphanol(1 mg)(Group DB)or saline(Group D).Subsequently,both groups were sedated using a loading dose of 1.0 pg/kg/h of dexmedetomidine.Hemodynamic and respiratory parameters,the time to attain sufficient sedation,wakeup time,and adverse events during DISE were recorded.Results:Compared with Group D,the time until sufficient sedation and wakeup time in Group DB were significantly reduced.A higher performer satisfaction level was achieved in Group DB.Patients in Group DB showed a higher incidence of bradycardia compared with Group D.However,the bradycardia resolved spontaneously in both groups without any treatment.There was no instance of cough,hypotension,arrhythmia,nausea or vomiting in either group.Conclusion:Compared to dexmedetomidine alone,a small dose of butorphanol infusion(1 mg)as an adjunct treatment to dexmedetomidine during DISE can reduce the dosage of dexmedetomidine,shorten the time until sufficient sedation and enhance the performer satisfaction level.This synergistic combination could be a promising sedation regimen for DISE in terms of procedural convenience and patient safety.展开更多
Objective To explore characteristics of clinical parameters and cytokines in patients with drug-induced liver injury(DILI)caused by different drugs and their correlation with clinical indicators.Method The study was c...Objective To explore characteristics of clinical parameters and cytokines in patients with drug-induced liver injury(DILI)caused by different drugs and their correlation with clinical indicators.Method The study was conducted on patients who were up to Review of Uncertainties in Confidence Assessment for Medical Tests(RUCAM)scoring criteria and clinically diagnosed with DILI.Based on Chinese herbal medicine,cardiovascular drugs,non-steroidal anti-inflammatory drugs(NSAIDs),antiinfective drugs,and other drugs,patients were divided into five groups.Cytokines were measured by Luminex technology.Baseline characteristics of clinical biochemical indicators and cytokines in DILI patients and their correlation were analyzed.Results 73 patients were enrolled.Age among five groups was statistically different(P=0.032).Alanine aminotransferase(ALT)(P=0.033)and aspartate aminotransferase(AST)(P=0.007)in NSAIDs group were higher than those in chinese herbal medicine group.Interleukin-6(IL-6)and tumor necrosis factor alpha(TNF-α)in patients with Chinese herbal medicine(IL-6:P<0.001;TNF-α:P<0.001)and cardiovascular medicine(IL-6:P=0.020;TNF-α:P=0.001)were lower than those in NSAIDs group.There was a positive correlation between ALT(r=0.697,P=0.025),AST(r=0.721,P=0.019),and IL-6 in NSAIDs group.Conclusion Older age may be more prone to DILI.Patients with NSAIDs have more severe liver damage in early stages of DILI,TNF-αand IL-6 may partake the inflammatory process of DILI.展开更多
Objective:To study the effect of Yigan capsule on the expression of high mobility group protein B1(HMGB1),nuclear factor-B(NF-κB)and receptor for advanced glycation end products(RAGE)in anti-tuberculosis drug-induced...Objective:To study the effect of Yigan capsule on the expression of high mobility group protein B1(HMGB1),nuclear factor-B(NF-κB)and receptor for advanced glycation end products(RAGE)in anti-tuberculosis drug-induced liver injury(ATB-DILI),and to explore its protective effect and mechanism on ATB-DILI,so as to provide experimental basis for the clinical application of Yigan capsule.Methods:Twenty-four rats were divided into two groups.Except for the blank group(n=6),the other 18 rats were given isoniazid(INH)+rifampicin(RFP)(50 mg/kg.d)for 4 weeks.Then 18 rats were randomly divided into three groups(model group,low dose group of Yigan capsule and high dose group of Yigan capsule)according to 6 rats in each group.The blank group and the model group were given 0.9%sodium chloride solution by intragastric administration.The low dose group of Yigan capsule was 0.468 g/kg,and the high dose group of Yigan capsule was 1.872 g/kg[1].After 4 weeks,the pathological changes of liver were observed by HE staining.The contents of ALT,AST,ALP,γ-GT and TBIL were detected.The expression of HMGB1,NF-κBp65 and RAGE protein was detected by IHC.The expression levels of HMGB1,NF-κBp65,RAGE,TNF-αand IL-1βwere detected by WB.Result:HE staining showed that the structure of the liver in the model group was disordered,the liver cells showed swelling and fusion,the number of inflammatory cells increased and accompanied by punctate necrosis,while the above pathological changes in each treatment group of Yigan capsule were significantly improved.The contents of ALT,AST,ALP,γ-GT and TBIL in the model group were higher than those in the blank group(P<0.05).The contents of ALT,AST,ALP,γ-GT and TBIL in each treatment group were significantly lower than those in the model group(P<0.05).Compared with the blank group,the expression levels of TNF-αand IL-1βin the model group were increased(P<0.05),and the expression levels of HMGB1,NF-κBp65 and RAGE were increased(P<0.05).Compared with the model group,the expression levels of TNF-αand IL-1βin each treatment group of Yigan capsule decreased(P<0.05),and the expression of HMGB1,NF-κBp65 and RAGE decreased(P<0.05).Conclusion:Yigan capsule may inhibit the secretion of inflammatory factors through HMGB1/RAGE/NF-κBp65 signaling pathway,thus protecting ATB-DILI.展开更多
The field of drug-induced sleep endoscopy(DISE)has grown considerably over the last 10~15 years,to now include its use in pediatric patients.In this review article,we outline our approach to the use of this technology...The field of drug-induced sleep endoscopy(DISE)has grown considerably over the last 10~15 years,to now include its use in pediatric patients.In this review article,we outline our approach to the use of this technology in Children with Airway Obstruction,most specifically in the management of children with airway obstruction and known or suspected adenotonsillar enlargement.展开更多
Drug-induced interstitial lung disease(DILD)is the most common pulmonary adverse event of anticancer drugs.In recent years,the incidence of anticancer DILD has gradually increased with the rapid development of novel a...Drug-induced interstitial lung disease(DILD)is the most common pulmonary adverse event of anticancer drugs.In recent years,the incidence of anticancer DILD has gradually increased with the rapid development of novel anticancer agents.Due to the diverse clinical manifestations and the lack of specific diagnostic criteria,DILD is difficult to diagnose and may even become fatal if not treated properly.Herein,a multidisciplinary group of experts from oncology,respiratory,imaging,pharmacology,pathology,and radiology departments in China has reached the“expert consensus on the diagnosis and treatment of anticancer DILD”after several rounds of a comprehensive investigation.This consensus aims to improve the awareness of clinicians and provide recommendations for the early screening,diagnosis,and treatment of anticancer DILD.This consensus also emphasizes the importance of multidisciplinary collaboration while managing DILD.展开更多
Drug-induced liver injury(DILI)is caused by various drugs with complex pathogenesis,and diverse clinical and pathological phenotypes.Drugs damage the liver directly through drug hepatotoxicity,or indirectly through dr...Drug-induced liver injury(DILI)is caused by various drugs with complex pathogenesis,and diverse clinical and pathological phenotypes.Drugs damage the liver directly through drug hepatotoxicity,or indirectly through drug-mediated oxidative stress,immune injury and inflammatory insult,which eventually lead to hepatocyte necrosis.Recent studies have found that the composition,relative content and distribution of gut microbiota in patients and animal models of DILI have changed significantly.It has been confirmed that gut microbial dysbiosis brings about intestinal barrier destruction and microorganisms translocation,and the alteration of microbial metabolites may cause or aggravate DILI.In addition,antibiotics,probiotics,and fecal microbiota transplantation are all emerging as prospective therapeutic methods for DILI by regulating the gut microbiota.In this review,we discussed how the altered gut microbiota participates in DILI.展开更多
BACKGROUND Interleukin-17(IL-17)inhibitors are known to cause exacerbation or new onset of inflammatory bowel disease upon administration.However,few reports have described characteristic endoscopic and histopathologi...BACKGROUND Interleukin-17(IL-17)inhibitors are known to cause exacerbation or new onset of inflammatory bowel disease upon administration.However,few reports have described characteristic endoscopic and histopathologic findings,and no small intestinal lesions have been reported so far.CASE SUMMARY A woman in her 60s with psoriasis was administered ixekizumab(IXE),an anti-IL-17A antibody,for the treatment of psoriasis.Twenty months after commencing treatment,the patient visited our hospital because of persistent diarrhea.Blood tests performed at the time of the visit revealed severe inflammation,and colonoscopy revealed multiple round ulcers throughout the colon.A tissue biopsy of the ulcer revealed infiltration of inflammatory cells and granuloma-like findings in the submucosal layer.Capsule endoscopy revealed multiple jejunal erosions.After the withdrawal of IXE,the symptoms gradually improved,and ulcer reduction and scarring of the colon were endoscopically confirmed.CONCLUSION To the best of our knowledge,17 reports have documented IL-17 inhibitorinduced entero-colitis with endoscopic images,endoscopic findings,and pathological characteristics,including the present case.Nine of these cases showed diffuse loss of vascular pattern,coarse mucosa/ulcer formation in the left colon,and endoscopic findings similar to those of ulcerative colitis.In the remaining eight cases,discontinuous erosions and ulcerations from the terminal ileum to the rectum were seen,with endoscopic findings similar to those of Crohn’s disease.In this case,the findings were confirmed by capsule endoscopy,which has not been previously reported.展开更多
BACKGROUND Empirical use of potentially hepatotoxic drugs in the management of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection is considered as one of the major etiopathogenetic factors for liver ...BACKGROUND Empirical use of potentially hepatotoxic drugs in the management of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection is considered as one of the major etiopathogenetic factors for liver injury.Recent evidence has shown that an underlying genetic factor may also occur.Hence,it is important to understand the host genetics and iatrogenic-based mechanisms for liver dysfunction to make timely remedial measures.AIM To investigate drug-induced and genetic perspectives for the development of coronavirus disease 2019(COVID-19)-related liver injury.METHODS Reference Citation Analysis,PubMed,Google Scholar and China National Knowledge Infrastructure were searched by employing the relevant MeSH keywords and pertaining data of the duration,site and type of study,sample size with any subgroups and drug-induced liver injury outcome.Genetic aspects were extracted from the most current pertinent publications.RESULTS In all studies,the hepatic specific aminotransferase and other biochemical indices were more than their prescribed upper normal limit in COVID-19 patients and were found to be significantly related with the gravity of disease,hospital stay,number of COVID-19 treatment drugs and worse clinical outcomes.In addition,membrane bound O-acyltransferase domain containing 7 rs641738,rs11385942 G>GA at chromosome 3 gene cluster and rs657152 C>A at ABO blood locus was significantly associated with severity of livery injury in admitted SARS-CoV-2 patients.CONCLUSION Hepatic dysfunction in SARS-CoV-2 infection could be the result of individual drugs or due to drug-drug interactions and may be in a subset of patients with a geneticpropensity. Thus, serial estimation of hepatic indices in hospitalized SARS-CoV-2 patients shouldbe done to make timely corrective actions for iatrogenic causes to avoid clinical deterioration.Additional molecular and translational research is warranted in this regard.展开更多
Background: Magnesium, an essential mineral crucial for various bodily functions, has been shown to positively influence sleep patterns. This study aimed to evaluate the efficacy of Food-Grown® magnesium in enhan...Background: Magnesium, an essential mineral crucial for various bodily functions, has been shown to positively influence sleep patterns. This study aimed to evaluate the efficacy of Food-Grown® magnesium in enhancing sleep quality and duration, as well as overall well-being. Methods: Eighty participants were randomly assigned to receive either 80 mg of Food-Grown® magnesium or a placebo (microcrystalline cellulose) daily for 8 weeks. Participants completed questionnaires assessing sleep quality, daytime drowsiness, quality of life, anxiety, and stress levels. Additionally, participants maintained daily sleep diaries and wore wrist-worn actigraphy devices. The primary outcome measured was the change in sleep quality and duration. Results: Seventy-one participants fulfilled all study requirements (35 in the active group and 36 in the placebo group). Magnesium supplementation significantly improved reported sleep quality, with the active group showing a 32% increase compared to 16% in the placebo group (p = 0.034). Moreover, magnesium supplementation led to a decrease in reported stress scores at week 8 compared to the placebo group (3.7 ± 2.6 vs. 5.5 ± 3.1, respectively). Both the magnesium and placebo groups exhibited significant increases in reported sleep duration and reductions in time to fall asleep, sleep disturbance, sleep latency, sleep medication usage, and total Pittsburgh Sleep Quality Index score at week 8 compared to baseline. Conclusion: Magnesium supplementation notably enhanced sleep quality and reduced stress levels compared to the placebo group. These findings highlight the potential of magnesium as a beneficial supplement for improving sleep quality and overall well-being.展开更多
Objective:To determine the level of agreement among experienced operators of candidacy for upper airway stimulation (UAS) based on evaluation of drug-induced sleep endoscopy (DISE).Methods:The trial was designed as a ...Objective:To determine the level of agreement among experienced operators of candidacy for upper airway stimulation (UAS) based on evaluation of drug-induced sleep endoscopy (DISE).Methods:The trial was designed as a single-blinded cross-sectional study.Four otolaryngologists with extensive DISE experience were given 63 video clips from the STAR trial video library.These videos were graded using the VOTE classification.Percentage agreement and Cohen's k (for inter-rater reliability) were calculated between pairs of reviewers,assessing palatal complete concentric collapse (CCC) and determining UAS eligibility.Subjects were also grouped based on collapse severity for each reviewer.Results:The reviewers had excellent (approximately 90%) agreement on findings at the level of the soft palate and tongue base.The inter-rater reliability for palatal CCC ranged from mod erate to substantial The agreement on determining the criteria for UAS implantation ranged from poor to moderate.All 4 upper airway structures as classified by the criteria of the VOTE were graded by all the reviewers as contributing to obstruction in a majority of subjects who were performed via application of DISE.Conclusion:Application of DISE remains a subjective examination,even among those experienced operators,therefore more studies need to be performed for evaluation of improvement in inter-rater reliability after implantation of training videos.展开更多
BACKGROUND A 70-year-old man with hepatitis C virus-related recurrent hepatocellular carcinoma was admitted for further diagnosis of a 1 cm iso-hyperechoic nodule in segment(S)5.CASE SUMMARY Gadolinium ethoxybenzyl di...BACKGROUND A 70-year-old man with hepatitis C virus-related recurrent hepatocellular carcinoma was admitted for further diagnosis of a 1 cm iso-hyperechoic nodule in segment(S)5.CASE SUMMARY Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging(EOB-MRI)revealed the nodule in S5 with a defect at the hepatobiliary phase,hyperintensity on diffusion weighted imaging(DWI)and hypointensity on apparent diffusion coefficient(ADC)map.Contrast-enhanced computed tomography revealed hypervascularity at the early phase,and delayed contrast-enhancement was observed at the late phase.Contrast-enhanced ultrasound(US)revealed incomplete defect at the late vascular phase.Inflammatory liver tumor,lymphoproliferative disease,intrahepatic cholangiocarcinoma(small duct type)and bile duct adenoma were suspected through the imaging studies.US guided biopsy,however,showed a noncaseating hepatic sarcoid-like epithelioid granuloma(HSEG),and histopathological analysis disclosed spindle shaped epithelioid cells harboring Langhans-type multinucleated giant cells.One month after admission,EOB-MRI signaled the disappearance of the defect at the hepatobiliary phase,of hyperintensity on DWI,of hypointensity on ADC map,and no stain at the early phase.CONCLUSION That the patient had received BNT162b2 messenger RNA(mRNA)coronavirus disease 2019 vaccination 3 mo before the occurrence of HSEG,and that its disappearance was confirmed 4 mo after mRNA vaccination suggested that the drug-induced sarcoidosis-like reaction(DISR)might be induced by the mRNA vaccination.Fortunately,rechallenge of drug-induced DISR with the third mRNA vaccination was not confirmed.展开更多
Studies have shown that non-alcoholic fatty liver disease(NAFLD)may be associated with sleep disorders.In order to explore the explicit relationship between the two,we systematically reviewed the effects of sleep diso...Studies have shown that non-alcoholic fatty liver disease(NAFLD)may be associated with sleep disorders.In order to explore the explicit relationship between the two,we systematically reviewed the effects of sleep disorders,especially obstructive sleep apnea(OSA),on the incidence of NAFLD,and analyzed the possible mechanisms after adjusting for confounding factors.NAFLD is independently associated with sleep disorders.Different sleep disorders may be the cause of the onset and aggravation of NAFLD.An excessive or insufficient sleep duration,poor sleep quality,insomnia,sleep-wake disorders,and OSA may increase the incidence of NAFLD.Despite that some research suggests a unidirectional causal link between the two,specifically,the onset of NAFLD is identified as a result of changes in sleep characteristics,and the reverse relationship does not hold true.Nevertheless,there is still a lack of specific research elucidating the reasons behind the higher risk of developing sleep disorders in individuals with NAFLD.Further research is needed to establish a clear relationship between NAFLD and sleep disorders.This will lay the groundwork for earlier identification of potential patients,which is crucial for earlier monitoring,diagnosis,effective prevention,and treatment of NAFLD.展开更多
Astrocytes are functionally dynamic cells that support neurons in multiple ways throughout an organism’s lifespan.The astrocytic regulation of neuronal activity has been increasingly recognized in recent years.Astroc...Astrocytes are functionally dynamic cells that support neurons in multiple ways throughout an organism’s lifespan.The astrocytic regulation of neuronal activity has been increasingly recognized in recent years.Astrocytes are now recognized as playing a more complex role than mere bystanders in the central nervous system.However,their role in regulating the sleep neurocircuitry is not well understood.From this perspective,we highlight the role of astrocytes in sleep modulation,with a particular focus on regulatory mechanisms related to the ventrolateral preoptic nucleus(VLPO)of the hypothalamus.We briefly discuss recent literature reporting the role of VLPO astrocytes in regulating sleep-associated behaviors.展开更多
Research Background: Compared to the general population, people experiencing age-related cognitive decline are more likely to have low levels of physical activity and sleep problems. Sufficient physical activity and q...Research Background: Compared to the general population, people experiencing age-related cognitive decline are more likely to have low levels of physical activity and sleep problems. Sufficient physical activity and quality sleep are protective factors against cognitive decline and poor health and can improve coping with stressors. The “Active Feedback” intervention comprises a wearable activity and sleep tracker (Fitbit), access to Fitbit software healthy lifestyle software apps;one session with Memory Assessment Service (MAS) staff providing physical activity and sleep hygiene advice and two further engagement, discussion, and feedback sessions. Purpose/Aim: This study investigates the acceptability and feasibility of Active Feedback and the effect on stress, mental wellbeing, and sleep quality, and the links between these factors. Methods: An open-label patient cohort design with no control group was used. Pre-intervention, 4-week and 8-week intervention assessments were performed using participant self-report measures: Perceived Stress Scale (PSS), Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), and Sleep Conditioning Index (SCI). Twenty-five participants completed an eight-week three-session intervention (18 males and 7 females), with the age range of 66 - 84 years old, and average age of 73.8 years (SD = 5.09). Fifteen participants had a diagnosis of MCI, ten participants did not. Results: There were non-significant improvements in SCI scores from 21.0 (SD = 8.84) to 21.6 (SD = 6.20) at 8 weeks, PSS scores from 17.5 (SD = 5.89) to 17.0 (SD = 6.20) at 8 weeks, and WEMWBS scores from 46.9 (SD = 9.23) to 48.8 (SD = 9.69) at 8 weeks. There were negative correlations between WEMWBS and PSS. Conclusion: Active Feedback intervention was found to be feasible and acceptable. Active Feedback could be enhanced to include motivational interviewing and goal setting.展开更多
Sleep plays a vital role in restoring the physical and mental health of people with cardiovascular disease.However,the hospital setting is not a conducive environment for sleep.Sleep interruptions by members of the ca...Sleep plays a vital role in restoring the physical and mental health of people with cardiovascular disease.However,the hospital setting is not a conducive environment for sleep.Sleep interruptions by members of the care team,including vital sign checks,medication delivery,and blood draws for laboratory investigations,are routinely done in many hospitals.Frequent interruptions by staff and noise by other patients have been cited as barriers to restorative sleep in the hospital.展开更多
Background Postoperative sleep disturbance(PSD)is a common and serious postoperative complication and is associated with poor postoperative outcomes.Aims This study aimed to investigate the effect of transcranial dire...Background Postoperative sleep disturbance(PSD)is a common and serious postoperative complication and is associated with poor postoperative outcomes.Aims This study aimed to investigate the effect of transcranial direct current stimulation(tDCS)on PSD in older patients undergoing lower limb major arthroplasty.Methods In this prospective,double-blind,pilot,randomised,sham-controlled trial,patients 65 years and over undergoing lower limb major arthroplasty were randomly assigned to receive active tDCS(a-tDCS)or sham tDCS(s-tDCS).The primary outcomes were the objective sleep measures on postoperative nights(N)1 and N2.Results 116 inpatients were assessed for eligibility,and a total of 92 patients were enrolled;47 received a-tDCS and 45 received s-tDCS.tDCS improved PSD by altering the following sleep measures in the a-tDCS and s-tDCS groups;the respective comparisons were as follows:the promotion of rapid eye movement(REM)sleep time on N1(64.5(33.5-105.5)vs 19.0(0.0,45.0)min,F=20.10,p<0.001)and N2(75.0(36.0-120.8)vs 30.0(1.3-59.3)min,F=12.55,p<0.001);the total sleep time on N1(506.0(408.0-561.0)vs 392.0(243.0-483.5)min,F=14.13,p<0.001)and N2(488.5(455.5-548.5)vs 346.0(286.5-517.5)min,F=7.36,p=0.007);the deep sleep time on N1(130.0(103.3-177.0)vs 42.5(9.8-100.8)min,F=24.4,p<0.001)and N2(103.5(46.0-154.8)vs 57.5(23.3-106.5)min,F=8.4,p=0.004);and the percentages of light sleep and REM sleep on N1 and N2(p<0.05 for each).The postoperative depression and anxiety scores did not differ significantly between the two groups.No significant adverse events were reported.Conclusion In older patients undergoing lower limb major arthroplasty,a single session of anodal tDCS over the left dorsolateral prefrontal cortex showed a potentially prophylactic effect in improving postoperative short-term objective sleep measures.However,this benefit was temporary and was not maintained over time.展开更多
Background Sleep disturbance is a common comorbidity of major depressive disorder(MDD).However,network homogeneity(NH)changes of the default mode network(DMN)in MDD with sleep disturbances are unclear.Aims The purpose...Background Sleep disturbance is a common comorbidity of major depressive disorder(MDD).However,network homogeneity(NH)changes of the default mode network(DMN)in MDD with sleep disturbances are unclear.Aims The purpose of this study was to probe the abnormal NH in the DMN in MDD with sleep disturbances and to reveal the differences between MDD with or without sleep disturbances.Methods Twenty-four patients with MDD and sleep disturbances(Pa_s),33 patients with MDD without sleep disturbances(Pa_ns)and 32 healthy controls(HCs)were recruited in this study.Resting-state functional imaging data were analysed using NH.Results Compared with Pa_ns and HCs,Pa_s showed decreased NH in the left superior medial prefrontal cortex and increased NH in the right precuneus.There was a negative correlation between NH in the left superior medial prefrontal cortex and sleep disturbances(r=−0.42,p=0.001)as well as a positive correlation between NH in the right precuneus and sleep disturbances(r=0.41,p=0.002)in patients with MDD.Conclusions MDD with sleep disturbances is associated with abnormal NH in the DMN,which could differentiate pa_s from pa_ns.The DMN may play a crucial role in the neurobiological mechanisms of MDD with sleep disturbances.展开更多
To the editor:It is commonly reported that people with insomnia often experience comorbid emotional disorders,such as mood and anxiety disorders.12 A study found that fragmented rapid eye movement(REM)sleep in individ...To the editor:It is commonly reported that people with insomnia often experience comorbid emotional disorders,such as mood and anxiety disorders.12 A study found that fragmented rapid eye movement(REM)sleep in individuals with insomnia is associated with higher Beck Depression Inventory(BDI)scores.3 REM sleep architecture disruption is a typical symptom of insomnia.展开更多
Background and Objective: With the popularity and widespread use of mobile phones, the effects of mobile phone dependence and addiction on individuals’ physical and mental health have attracted more and more attentio...Background and Objective: With the popularity and widespread use of mobile phones, the effects of mobile phone dependence and addiction on individuals’ physical and mental health have attracted more and more attention. The present study aims to analyze the current state of mobile phone addiction and its impact on sleep quality within the population, while also exploring the influence of related factors on sleep quality. Ultimately, this research will provide a scientific foundation for targeted intervention measures and strategies. Methods: A total of 253 permanent residents in Nanjing were randomly selected as study subjects. The Mobile Phone Addiction Index (MPAI) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the degree of smartphone addiction and sleep quality of the study subjects. Body mass index (BMI) was measured according to standardized procedures. Independent sample t-test, Chi-square test, rank sum test and multiple linear regression were used to analyze the correlation between mobile phone addiction and sleep quality, and P Results: 117 people (46.2%) were addicted to mobile phones. Chi-square test showed that the rate of mobile phone addiction in drinking group was significantly higher than that in non-drinking group (P P P P P P P P P P Conclusion: Mobile phone addiction may lead to shorter sleep duration and reduce sleep efficiency. The withdrawal of mobile phone addiction may have a negative impact on sleep quality. According to the characteristics of the population, appropriate comprehensive intervention measures should be taken to build an effective evaluation system, so as to reduce the impact of mobile phone addiction and withdrawal problems on sleep and improve sleep quality.展开更多
基金supported by the National Natural Science Foundation of China(No.81470677)the Natural Science Foundation of Hubei Province(No.2020CFB562).
文摘Objective:Drug-induced sleep endoscopy(DISE)allows for the evaluation of dynamic airway collapse in patients with obstructive sleep apnea.However,a standardized sedation regimen for DISE is not yet available.This study aimed to investigate the safety profiles and efficacies of dexmedetomidine combined with butorphanol for DISE.Methods:Sixty patients with obstructive sleep apnea scheduled to undergo DISE were randomly divided into Group D and Group DB.All recipients were initially given intravenous butorphanol(1 mg)(Group DB)or saline(Group D).Subsequently,both groups were sedated using a loading dose of 1.0 pg/kg/h of dexmedetomidine.Hemodynamic and respiratory parameters,the time to attain sufficient sedation,wakeup time,and adverse events during DISE were recorded.Results:Compared with Group D,the time until sufficient sedation and wakeup time in Group DB were significantly reduced.A higher performer satisfaction level was achieved in Group DB.Patients in Group DB showed a higher incidence of bradycardia compared with Group D.However,the bradycardia resolved spontaneously in both groups without any treatment.There was no instance of cough,hypotension,arrhythmia,nausea or vomiting in either group.Conclusion:Compared to dexmedetomidine alone,a small dose of butorphanol infusion(1 mg)as an adjunct treatment to dexmedetomidine during DISE can reduce the dosage of dexmedetomidine,shorten the time until sufficient sedation and enhance the performer satisfaction level.This synergistic combination could be a promising sedation regimen for DISE in terms of procedural convenience and patient safety.
基金funded by The National Key Research and Development Program(2022YFC2603500,2022YFC2603505)Beijing Municipal Health Commission high-level public health technical personnel construction project,discipline leader-03-26+2 种基金Beijing Hospitals Authority Clinical medicine Development of special funding support(XMLX202127)The Digestive Medical Coordinated Development Center of Beijing Hospitals Authority(XXZ0302)The capital health research and development of special(2022-1-2172)。
文摘Objective To explore characteristics of clinical parameters and cytokines in patients with drug-induced liver injury(DILI)caused by different drugs and their correlation with clinical indicators.Method The study was conducted on patients who were up to Review of Uncertainties in Confidence Assessment for Medical Tests(RUCAM)scoring criteria and clinically diagnosed with DILI.Based on Chinese herbal medicine,cardiovascular drugs,non-steroidal anti-inflammatory drugs(NSAIDs),antiinfective drugs,and other drugs,patients were divided into five groups.Cytokines were measured by Luminex technology.Baseline characteristics of clinical biochemical indicators and cytokines in DILI patients and their correlation were analyzed.Results 73 patients were enrolled.Age among five groups was statistically different(P=0.032).Alanine aminotransferase(ALT)(P=0.033)and aspartate aminotransferase(AST)(P=0.007)in NSAIDs group were higher than those in chinese herbal medicine group.Interleukin-6(IL-6)and tumor necrosis factor alpha(TNF-α)in patients with Chinese herbal medicine(IL-6:P<0.001;TNF-α:P<0.001)and cardiovascular medicine(IL-6:P=0.020;TNF-α:P=0.001)were lower than those in NSAIDs group.There was a positive correlation between ALT(r=0.697,P=0.025),AST(r=0.721,P=0.019),and IL-6 in NSAIDs group.Conclusion Older age may be more prone to DILI.Patients with NSAIDs have more severe liver damage in early stages of DILI,TNF-αand IL-6 may partake the inflammatory process of DILI.
基金Scientific Research Project of Heilongjiang Provincial Education Department(No.12531608)。
文摘Objective:To study the effect of Yigan capsule on the expression of high mobility group protein B1(HMGB1),nuclear factor-B(NF-κB)and receptor for advanced glycation end products(RAGE)in anti-tuberculosis drug-induced liver injury(ATB-DILI),and to explore its protective effect and mechanism on ATB-DILI,so as to provide experimental basis for the clinical application of Yigan capsule.Methods:Twenty-four rats were divided into two groups.Except for the blank group(n=6),the other 18 rats were given isoniazid(INH)+rifampicin(RFP)(50 mg/kg.d)for 4 weeks.Then 18 rats were randomly divided into three groups(model group,low dose group of Yigan capsule and high dose group of Yigan capsule)according to 6 rats in each group.The blank group and the model group were given 0.9%sodium chloride solution by intragastric administration.The low dose group of Yigan capsule was 0.468 g/kg,and the high dose group of Yigan capsule was 1.872 g/kg[1].After 4 weeks,the pathological changes of liver were observed by HE staining.The contents of ALT,AST,ALP,γ-GT and TBIL were detected.The expression of HMGB1,NF-κBp65 and RAGE protein was detected by IHC.The expression levels of HMGB1,NF-κBp65,RAGE,TNF-αand IL-1βwere detected by WB.Result:HE staining showed that the structure of the liver in the model group was disordered,the liver cells showed swelling and fusion,the number of inflammatory cells increased and accompanied by punctate necrosis,while the above pathological changes in each treatment group of Yigan capsule were significantly improved.The contents of ALT,AST,ALP,γ-GT and TBIL in the model group were higher than those in the blank group(P<0.05).The contents of ALT,AST,ALP,γ-GT and TBIL in each treatment group were significantly lower than those in the model group(P<0.05).Compared with the blank group,the expression levels of TNF-αand IL-1βin the model group were increased(P<0.05),and the expression levels of HMGB1,NF-κBp65 and RAGE were increased(P<0.05).Compared with the model group,the expression levels of TNF-αand IL-1βin each treatment group of Yigan capsule decreased(P<0.05),and the expression of HMGB1,NF-κBp65 and RAGE decreased(P<0.05).Conclusion:Yigan capsule may inhibit the secretion of inflammatory factors through HMGB1/RAGE/NF-κBp65 signaling pathway,thus protecting ATB-DILI.
文摘The field of drug-induced sleep endoscopy(DISE)has grown considerably over the last 10~15 years,to now include its use in pediatric patients.In this review article,we outline our approach to the use of this technology in Children with Airway Obstruction,most specifically in the management of children with airway obstruction and known or suspected adenotonsillar enlargement.
基金supported by grants from CAMS Innovation Fund for Medical Sciences(CIFMS)(No.2021-I2M-1-014)and National Key R&D Program of China(No.2021YFC2500700).
文摘Drug-induced interstitial lung disease(DILD)is the most common pulmonary adverse event of anticancer drugs.In recent years,the incidence of anticancer DILD has gradually increased with the rapid development of novel anticancer agents.Due to the diverse clinical manifestations and the lack of specific diagnostic criteria,DILD is difficult to diagnose and may even become fatal if not treated properly.Herein,a multidisciplinary group of experts from oncology,respiratory,imaging,pharmacology,pathology,and radiology departments in China has reached the“expert consensus on the diagnosis and treatment of anticancer DILD”after several rounds of a comprehensive investigation.This consensus aims to improve the awareness of clinicians and provide recommendations for the early screening,diagnosis,and treatment of anticancer DILD.This consensus also emphasizes the importance of multidisciplinary collaboration while managing DILD.
基金This study was supported by grants from the National Natu-ral Science Foundation of China(82000561,81974078,81570530,81370550,81974062,81720108006)the Natural Science Founda-tion of Hubei Province(2019ACA1333)the Science Foundation of Union Hospital(2021xhyn005).
文摘Drug-induced liver injury(DILI)is caused by various drugs with complex pathogenesis,and diverse clinical and pathological phenotypes.Drugs damage the liver directly through drug hepatotoxicity,or indirectly through drug-mediated oxidative stress,immune injury and inflammatory insult,which eventually lead to hepatocyte necrosis.Recent studies have found that the composition,relative content and distribution of gut microbiota in patients and animal models of DILI have changed significantly.It has been confirmed that gut microbial dysbiosis brings about intestinal barrier destruction and microorganisms translocation,and the alteration of microbial metabolites may cause or aggravate DILI.In addition,antibiotics,probiotics,and fecal microbiota transplantation are all emerging as prospective therapeutic methods for DILI by regulating the gut microbiota.In this review,we discussed how the altered gut microbiota participates in DILI.
文摘BACKGROUND Interleukin-17(IL-17)inhibitors are known to cause exacerbation or new onset of inflammatory bowel disease upon administration.However,few reports have described characteristic endoscopic and histopathologic findings,and no small intestinal lesions have been reported so far.CASE SUMMARY A woman in her 60s with psoriasis was administered ixekizumab(IXE),an anti-IL-17A antibody,for the treatment of psoriasis.Twenty months after commencing treatment,the patient visited our hospital because of persistent diarrhea.Blood tests performed at the time of the visit revealed severe inflammation,and colonoscopy revealed multiple round ulcers throughout the colon.A tissue biopsy of the ulcer revealed infiltration of inflammatory cells and granuloma-like findings in the submucosal layer.Capsule endoscopy revealed multiple jejunal erosions.After the withdrawal of IXE,the symptoms gradually improved,and ulcer reduction and scarring of the colon were endoscopically confirmed.CONCLUSION To the best of our knowledge,17 reports have documented IL-17 inhibitorinduced entero-colitis with endoscopic images,endoscopic findings,and pathological characteristics,including the present case.Nine of these cases showed diffuse loss of vascular pattern,coarse mucosa/ulcer formation in the left colon,and endoscopic findings similar to those of ulcerative colitis.In the remaining eight cases,discontinuous erosions and ulcerations from the terminal ileum to the rectum were seen,with endoscopic findings similar to those of Crohn’s disease.In this case,the findings were confirmed by capsule endoscopy,which has not been previously reported.
文摘BACKGROUND Empirical use of potentially hepatotoxic drugs in the management of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection is considered as one of the major etiopathogenetic factors for liver injury.Recent evidence has shown that an underlying genetic factor may also occur.Hence,it is important to understand the host genetics and iatrogenic-based mechanisms for liver dysfunction to make timely remedial measures.AIM To investigate drug-induced and genetic perspectives for the development of coronavirus disease 2019(COVID-19)-related liver injury.METHODS Reference Citation Analysis,PubMed,Google Scholar and China National Knowledge Infrastructure were searched by employing the relevant MeSH keywords and pertaining data of the duration,site and type of study,sample size with any subgroups and drug-induced liver injury outcome.Genetic aspects were extracted from the most current pertinent publications.RESULTS In all studies,the hepatic specific aminotransferase and other biochemical indices were more than their prescribed upper normal limit in COVID-19 patients and were found to be significantly related with the gravity of disease,hospital stay,number of COVID-19 treatment drugs and worse clinical outcomes.In addition,membrane bound O-acyltransferase domain containing 7 rs641738,rs11385942 G>GA at chromosome 3 gene cluster and rs657152 C>A at ABO blood locus was significantly associated with severity of livery injury in admitted SARS-CoV-2 patients.CONCLUSION Hepatic dysfunction in SARS-CoV-2 infection could be the result of individual drugs or due to drug-drug interactions and may be in a subset of patients with a geneticpropensity. Thus, serial estimation of hepatic indices in hospitalized SARS-CoV-2 patients shouldbe done to make timely corrective actions for iatrogenic causes to avoid clinical deterioration.Additional molecular and translational research is warranted in this regard.
文摘Background: Magnesium, an essential mineral crucial for various bodily functions, has been shown to positively influence sleep patterns. This study aimed to evaluate the efficacy of Food-Grown® magnesium in enhancing sleep quality and duration, as well as overall well-being. Methods: Eighty participants were randomly assigned to receive either 80 mg of Food-Grown® magnesium or a placebo (microcrystalline cellulose) daily for 8 weeks. Participants completed questionnaires assessing sleep quality, daytime drowsiness, quality of life, anxiety, and stress levels. Additionally, participants maintained daily sleep diaries and wore wrist-worn actigraphy devices. The primary outcome measured was the change in sleep quality and duration. Results: Seventy-one participants fulfilled all study requirements (35 in the active group and 36 in the placebo group). Magnesium supplementation significantly improved reported sleep quality, with the active group showing a 32% increase compared to 16% in the placebo group (p = 0.034). Moreover, magnesium supplementation led to a decrease in reported stress scores at week 8 compared to the placebo group (3.7 ± 2.6 vs. 5.5 ± 3.1, respectively). Both the magnesium and placebo groups exhibited significant increases in reported sleep duration and reductions in time to fall asleep, sleep disturbance, sleep latency, sleep medication usage, and total Pittsburgh Sleep Quality Index score at week 8 compared to baseline. Conclusion: Magnesium supplementation notably enhanced sleep quality and reduced stress levels compared to the placebo group. These findings highlight the potential of magnesium as a beneficial supplement for improving sleep quality and overall well-being.
文摘Objective:To determine the level of agreement among experienced operators of candidacy for upper airway stimulation (UAS) based on evaluation of drug-induced sleep endoscopy (DISE).Methods:The trial was designed as a single-blinded cross-sectional study.Four otolaryngologists with extensive DISE experience were given 63 video clips from the STAR trial video library.These videos were graded using the VOTE classification.Percentage agreement and Cohen's k (for inter-rater reliability) were calculated between pairs of reviewers,assessing palatal complete concentric collapse (CCC) and determining UAS eligibility.Subjects were also grouped based on collapse severity for each reviewer.Results:The reviewers had excellent (approximately 90%) agreement on findings at the level of the soft palate and tongue base.The inter-rater reliability for palatal CCC ranged from mod erate to substantial The agreement on determining the criteria for UAS implantation ranged from poor to moderate.All 4 upper airway structures as classified by the criteria of the VOTE were graded by all the reviewers as contributing to obstruction in a majority of subjects who were performed via application of DISE.Conclusion:Application of DISE remains a subjective examination,even among those experienced operators,therefore more studies need to be performed for evaluation of improvement in inter-rater reliability after implantation of training videos.
文摘BACKGROUND A 70-year-old man with hepatitis C virus-related recurrent hepatocellular carcinoma was admitted for further diagnosis of a 1 cm iso-hyperechoic nodule in segment(S)5.CASE SUMMARY Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging(EOB-MRI)revealed the nodule in S5 with a defect at the hepatobiliary phase,hyperintensity on diffusion weighted imaging(DWI)and hypointensity on apparent diffusion coefficient(ADC)map.Contrast-enhanced computed tomography revealed hypervascularity at the early phase,and delayed contrast-enhancement was observed at the late phase.Contrast-enhanced ultrasound(US)revealed incomplete defect at the late vascular phase.Inflammatory liver tumor,lymphoproliferative disease,intrahepatic cholangiocarcinoma(small duct type)and bile duct adenoma were suspected through the imaging studies.US guided biopsy,however,showed a noncaseating hepatic sarcoid-like epithelioid granuloma(HSEG),and histopathological analysis disclosed spindle shaped epithelioid cells harboring Langhans-type multinucleated giant cells.One month after admission,EOB-MRI signaled the disappearance of the defect at the hepatobiliary phase,of hyperintensity on DWI,of hypointensity on ADC map,and no stain at the early phase.CONCLUSION That the patient had received BNT162b2 messenger RNA(mRNA)coronavirus disease 2019 vaccination 3 mo before the occurrence of HSEG,and that its disappearance was confirmed 4 mo after mRNA vaccination suggested that the drug-induced sarcoidosis-like reaction(DISR)might be induced by the mRNA vaccination.Fortunately,rechallenge of drug-induced DISR with the third mRNA vaccination was not confirmed.
基金Supported by National Natural Science Foundation of China,No.82360880,and 82060661Jiangxi Provincial Natural Science Foundation of China,No.20232ACB206057+3 种基金Key project of Jiangxi Provincial Department of Education,No.GJJ218104Teaching reform research project of Jiangxi Province of China,No.JXJG-22-130-1National Natural Science Foundation of China,No.81660151Jiangxi Provincial Natural Science Foundation of China,No.20212BAB206092.
文摘Studies have shown that non-alcoholic fatty liver disease(NAFLD)may be associated with sleep disorders.In order to explore the explicit relationship between the two,we systematically reviewed the effects of sleep disorders,especially obstructive sleep apnea(OSA),on the incidence of NAFLD,and analyzed the possible mechanisms after adjusting for confounding factors.NAFLD is independently associated with sleep disorders.Different sleep disorders may be the cause of the onset and aggravation of NAFLD.An excessive or insufficient sleep duration,poor sleep quality,insomnia,sleep-wake disorders,and OSA may increase the incidence of NAFLD.Despite that some research suggests a unidirectional causal link between the two,specifically,the onset of NAFLD is identified as a result of changes in sleep characteristics,and the reverse relationship does not hold true.Nevertheless,there is still a lack of specific research elucidating the reasons behind the higher risk of developing sleep disorders in individuals with NAFLD.Further research is needed to establish a clear relationship between NAFLD and sleep disorders.This will lay the groundwork for earlier identification of potential patients,which is crucial for earlier monitoring,diagnosis,effective prevention,and treatment of NAFLD.
基金supported by a National Research Foundation of Korea(NRF)grant funded by the Korean government(2017R1A5A2015391 and 2020M3E5D9079764)(to KS).
文摘Astrocytes are functionally dynamic cells that support neurons in multiple ways throughout an organism’s lifespan.The astrocytic regulation of neuronal activity has been increasingly recognized in recent years.Astrocytes are now recognized as playing a more complex role than mere bystanders in the central nervous system.However,their role in regulating the sleep neurocircuitry is not well understood.From this perspective,we highlight the role of astrocytes in sleep modulation,with a particular focus on regulatory mechanisms related to the ventrolateral preoptic nucleus(VLPO)of the hypothalamus.We briefly discuss recent literature reporting the role of VLPO astrocytes in regulating sleep-associated behaviors.
文摘Research Background: Compared to the general population, people experiencing age-related cognitive decline are more likely to have low levels of physical activity and sleep problems. Sufficient physical activity and quality sleep are protective factors against cognitive decline and poor health and can improve coping with stressors. The “Active Feedback” intervention comprises a wearable activity and sleep tracker (Fitbit), access to Fitbit software healthy lifestyle software apps;one session with Memory Assessment Service (MAS) staff providing physical activity and sleep hygiene advice and two further engagement, discussion, and feedback sessions. Purpose/Aim: This study investigates the acceptability and feasibility of Active Feedback and the effect on stress, mental wellbeing, and sleep quality, and the links between these factors. Methods: An open-label patient cohort design with no control group was used. Pre-intervention, 4-week and 8-week intervention assessments were performed using participant self-report measures: Perceived Stress Scale (PSS), Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), and Sleep Conditioning Index (SCI). Twenty-five participants completed an eight-week three-session intervention (18 males and 7 females), with the age range of 66 - 84 years old, and average age of 73.8 years (SD = 5.09). Fifteen participants had a diagnosis of MCI, ten participants did not. Results: There were non-significant improvements in SCI scores from 21.0 (SD = 8.84) to 21.6 (SD = 6.20) at 8 weeks, PSS scores from 17.5 (SD = 5.89) to 17.0 (SD = 6.20) at 8 weeks, and WEMWBS scores from 46.9 (SD = 9.23) to 48.8 (SD = 9.69) at 8 weeks. There were negative correlations between WEMWBS and PSS. Conclusion: Active Feedback intervention was found to be feasible and acceptable. Active Feedback could be enhanced to include motivational interviewing and goal setting.
基金supported by a Clinical Research Award from the Fonds de recherche du Québec.
文摘Sleep plays a vital role in restoring the physical and mental health of people with cardiovascular disease.However,the hospital setting is not a conducive environment for sleep.Sleep interruptions by members of the care team,including vital sign checks,medication delivery,and blood draws for laboratory investigations,are routinely done in many hospitals.Frequent interruptions by staff and noise by other patients have been cited as barriers to restorative sleep in the hospital.
基金This study was supported in part by grants from the National Key R&D Program of China(2021ZD0203100 to JC)National Natural Science Foundation of China(NSFC81720108013,NSFC31771161 and NSFC81230025 to JC,NSFC81300957 and NSFC82171227 to HL,NSFC81771453 and NSFC31970937 to HZ)+6 种基金Jiangsu Provincial Special Program of Medical Science(BL2014029 to JC)Basic and Clinical Research Center in Anesthesiology of Jiangsu Provincial'Science and Education for Health'Project(JC),Zhejiang Provincial Natural Science Foundation(LY22H090019 to HL)Jiangsu Provincial Natural Science Foundation(BK20190047 to HZ)the Priority Academic Program Development of Jiangsu Higher Education Institutions(19KJA610005 to HZ)Distinguished Professor Program of Jiangsu(HZ),Jiangsu Province Innovative and Entrepreneurial Talent Program and Jiangsu Province Innovative and Entrepreneurial Team Program(HZ),Xuzhou Medical University start-up grant for excellent scientist(D2018010 and D2019025D to HZ)the Natural Science Foundation of Shanghai(21ZR1411300 to YH)Shenkang Clinical Study Foundation of Shanghai(SHDC2020CR4061 to YH).
文摘Background Postoperative sleep disturbance(PSD)is a common and serious postoperative complication and is associated with poor postoperative outcomes.Aims This study aimed to investigate the effect of transcranial direct current stimulation(tDCS)on PSD in older patients undergoing lower limb major arthroplasty.Methods In this prospective,double-blind,pilot,randomised,sham-controlled trial,patients 65 years and over undergoing lower limb major arthroplasty were randomly assigned to receive active tDCS(a-tDCS)or sham tDCS(s-tDCS).The primary outcomes were the objective sleep measures on postoperative nights(N)1 and N2.Results 116 inpatients were assessed for eligibility,and a total of 92 patients were enrolled;47 received a-tDCS and 45 received s-tDCS.tDCS improved PSD by altering the following sleep measures in the a-tDCS and s-tDCS groups;the respective comparisons were as follows:the promotion of rapid eye movement(REM)sleep time on N1(64.5(33.5-105.5)vs 19.0(0.0,45.0)min,F=20.10,p<0.001)and N2(75.0(36.0-120.8)vs 30.0(1.3-59.3)min,F=12.55,p<0.001);the total sleep time on N1(506.0(408.0-561.0)vs 392.0(243.0-483.5)min,F=14.13,p<0.001)and N2(488.5(455.5-548.5)vs 346.0(286.5-517.5)min,F=7.36,p=0.007);the deep sleep time on N1(130.0(103.3-177.0)vs 42.5(9.8-100.8)min,F=24.4,p<0.001)and N2(103.5(46.0-154.8)vs 57.5(23.3-106.5)min,F=8.4,p=0.004);and the percentages of light sleep and REM sleep on N1 and N2(p<0.05 for each).The postoperative depression and anxiety scores did not differ significantly between the two groups.No significant adverse events were reported.Conclusion In older patients undergoing lower limb major arthroplasty,a single session of anodal tDCS over the left dorsolateral prefrontal cortex showed a potentially prophylactic effect in improving postoperative short-term objective sleep measures.However,this benefit was temporary and was not maintained over time.
基金This study was supported by grants from the National Natural Science Foundation of China(Grant numbers:82171508 and 82071507).
文摘Background Sleep disturbance is a common comorbidity of major depressive disorder(MDD).However,network homogeneity(NH)changes of the default mode network(DMN)in MDD with sleep disturbances are unclear.Aims The purpose of this study was to probe the abnormal NH in the DMN in MDD with sleep disturbances and to reveal the differences between MDD with or without sleep disturbances.Methods Twenty-four patients with MDD and sleep disturbances(Pa_s),33 patients with MDD without sleep disturbances(Pa_ns)and 32 healthy controls(HCs)were recruited in this study.Resting-state functional imaging data were analysed using NH.Results Compared with Pa_ns and HCs,Pa_s showed decreased NH in the left superior medial prefrontal cortex and increased NH in the right precuneus.There was a negative correlation between NH in the left superior medial prefrontal cortex and sleep disturbances(r=−0.42,p=0.001)as well as a positive correlation between NH in the right precuneus and sleep disturbances(r=0.41,p=0.002)in patients with MDD.Conclusions MDD with sleep disturbances is associated with abnormal NH in the DMN,which could differentiate pa_s from pa_ns.The DMN may play a crucial role in the neurobiological mechanisms of MDD with sleep disturbances.
基金This work is supported by the National Natural Science Foundation of China(grant/award numbers:81871430,81871426,U22A20303,82260359)Hebei Provincial Natural Science Foundation(grant/award numbers:H2020206263,H2020206625)STI2030-Major Projects Program(grant/award number:2022ZD0214500).
文摘To the editor:It is commonly reported that people with insomnia often experience comorbid emotional disorders,such as mood and anxiety disorders.12 A study found that fragmented rapid eye movement(REM)sleep in individuals with insomnia is associated with higher Beck Depression Inventory(BDI)scores.3 REM sleep architecture disruption is a typical symptom of insomnia.
文摘Background and Objective: With the popularity and widespread use of mobile phones, the effects of mobile phone dependence and addiction on individuals’ physical and mental health have attracted more and more attention. The present study aims to analyze the current state of mobile phone addiction and its impact on sleep quality within the population, while also exploring the influence of related factors on sleep quality. Ultimately, this research will provide a scientific foundation for targeted intervention measures and strategies. Methods: A total of 253 permanent residents in Nanjing were randomly selected as study subjects. The Mobile Phone Addiction Index (MPAI) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the degree of smartphone addiction and sleep quality of the study subjects. Body mass index (BMI) was measured according to standardized procedures. Independent sample t-test, Chi-square test, rank sum test and multiple linear regression were used to analyze the correlation between mobile phone addiction and sleep quality, and P Results: 117 people (46.2%) were addicted to mobile phones. Chi-square test showed that the rate of mobile phone addiction in drinking group was significantly higher than that in non-drinking group (P P P P P P P P P P Conclusion: Mobile phone addiction may lead to shorter sleep duration and reduce sleep efficiency. The withdrawal of mobile phone addiction may have a negative impact on sleep quality. According to the characteristics of the population, appropriate comprehensive intervention measures should be taken to build an effective evaluation system, so as to reduce the impact of mobile phone addiction and withdrawal problems on sleep and improve sleep quality.