Zhonghua Yi Xue za Zhi [Chinese medical journal]

Excessive daytime sleepiness (EDS) afflicts more than 20% of the general population. It not only affects individuals' performance in many ways, but may even be life-threatening due to potential risks. Currently, there is no comprehensive diagnosis and treatment standard for EDS at home and abroad. To this end, the Chinese Sleep Research Society organized domestic experts in sleep medicine to develop this consensus based on the latest research on EDS. The current consensus elaborates on the definition, epidemiology, clinical manifestations, diagnostic approach, related etiology, evaluation, and treatment of EDS, aiming to provide comprehensive and standardized references and recommendations for the diagnosis and treatment of EDS...

Over the past decades, Chinese sports medicine has made remarkable progress, successfully establishing its status as a discipline and embracing unprecedented development opportunities. In the foreseeable future, "sports for health promotion", in addition to already fast development of "sports injury treatment" and "sports rehabilitation", will become the third vital advancing directions of sports medicine in China. The popularization and application of exercise prescription will become an effective and reliable approach to fulfill sports for health promotion...

Corona virus disease 2019 (COVID-19) can lead to thrombotic complications through multiple mechanisms. Venous thromboembolism (VTE) is one of the most important causes of death or poor prognosis in hospitalized patients with COVID-19. The prognosis of thrombosis in COVID-19 patients can be improved with VTE and bleeding risk assessment, as well as appropriate VTE prophylaxis. However, in current clinical practice, there still is much room for progress in choose of appropriate prevention methods, anticoagulant regimens, doses, and courses based on the severity and specific condition of COVID-19 patients and dynamically balancing the risk of thrombosis and bleeding...

Objective: To explore the predictive performance of image quantitative index model, clinical-laboratory index model and image-clinical multi-dimensional fusion model in predicting the prognosis of patients with aneurysmal subarachnoid hemorrhage (aSAH) with intraventricular hemorrhage (IVH). Methods: A total of 349 patients with aSAH and IVH, including 122 males and 227 females, aged 22 to 85 (59±11) years underwent CT scan in the General Hospital of Eastern Theater Command from January 2010 to December 2019 were used as dataset 1 to construct a prognostic model...

Objective: To investigate the effects of different accompanying symptoms on the risk of cardiovascular and cerebrovascular and diabetes events in patients with obstructive sleep apnea (OSA). Methods: Patients diagnosed with OSA in the sleep center of Tangdu Hospital from January 4, 2011 to December 28, 2016 were retrospectively collected and divided into four groups according to accompanying symptoms: group A included OSA patients without insomnia and excessive daytime sleepiness (EDS), group B included OSA patients with insomnia, group C included OSA patients with EDS and group D included OSA patients with insomnia and EDS...

Objective: To investigate the short-term clinical efficacy of posterior ankle arthroscopy combined with tendoscope on ankle-origin flexor hallucis longus tendon ganglion. Methods: A follow-up study. Clinical data of 10 patients with hallux ganglion underwent posterior ankle arthroscopy combined with flexor hallucis longus tendoscope in the Tianjin First Central Hospital from January to June 2021 were analyzed retrospectively. There were 5 males and 5 females with a mean age of 42.7 (22-54) years. Disease distribution: 6 patients were on the right side and 4 cases were on the left side...

Objective: To compare the clinical efficacy of a new generation of ligaments (LARS artificial ligament) and bone-patellar tendon-bone (BPTB) autograft as grafts in anterior cruciate ligament (ACL) revision. Methods: A retrospective cohort study. The clinical data of 54 patients who underwent ACL revision from January 2018 to June 2020 in the First Hospital Affiliated to Army Medical University were retrospectively analyzed. There were 44 males and 10 females with a mean age of (28.5±7.7) years (15-45 years)...

Objective: To investigate the mid-term clinical outcome of deep layer repair with the long head of the biceps autograft bridging for Kim classification type ⅠA delaminated rotator cuff tear. Methods: A follow-up study. The clinical data of 42 consecutive patients with Kim classification type ⅠA delaminated rotator cuff tear admitted to the First Affiliated Hospital of Jinan University from January 2018 to June 2019 were retrospectively included. All patients underwent shoulder arthroscopic surgery...

Objective: To evaluate the effect of fluoroscopy-free technique in the arthroscopic treatment of femoroacetabular impingement syndrome (FAIS). Methods: A retrospective cohort study. Clinical data of FAI patients treated with hip arthroscopy in the No.4 Medical Center, PLA General Hospital from October 2018 to December 2021 were retrospectively analyzed. The patients were divided into two groups according to the surgical procedure: the fluoroscopy group and the fluoroscopy-free group. The operation time and modified Harris hip score (mHHS), international hip outcome tool (iHOT12) and visual analogue scale (VAS) of hip joint pain before and after the operation were observed and compared between the two groups...

Objective: To explore whether the combination of anterior bony impingement before surgery will affect the efficacy of the lateral collateral ankle ligament reconstruction surgery in patients with chronic ankle instability (CAI). Methods: A prospective cohort study. Patients with CAI who underwent lateral collateral ankle ligament reconstruction from January 2014 to October 2017 in the Department of Sports Medicine, Huashan Hospital, Fudan University were enrolled in this study. The patients were divided into no bony impingement group (NI group) and bony impingement group (BI group) according to the presence of bone impingement in front of the ankle during the operation...

Patient-controlled intravenous analgesia (PCIA) is a common form of individualized treatment for cancer pain, and it has the characteristics of rapid onset, stable blood concentration and on-demand administration, which is suitable for patients who fail to take oral medicine or have poor pain control with oral medications. The preferred drugs for PCIA are strong opioids, which can be combined with sedative drugs according to the patient's condition. Dose titration is required prior to administration of PCIA, dynamic pain assessment should be performed during the use of PCIA, the dose should be adjusted at any time, and the adverse reactions should be closely monitored and treated in time...

Under the rapid development of national health and fitness, the incidence rates of bone-tendon injuries have been increasing observably. Bone-to-tendon healing poses a formidable clinical challenge due to the complex structure, composition and mechanics of the interface. A variety of strategies, including advanced biomaterials, bioactive growth factors and multiple stem cell lineages, have been developed, providing new adjuvant therapies for the repair of motor system injuries. Among them, tissue engineering of decellularized extracellular matrix materials is one of the most promising approaches...

The study aimed to evaluate whether an intra-aortic balloon pump (IABP) could improve the prognosis of patients with cardiogenic shock (CS) of Stage C (Classic), Stage D (Deteriorating), and Stage E (Extremis) based on Society for Cardiovascular Angiography and Interventions (SCAI) classification. The hospital information database was searched, and the patients who met the diagnostic criteria of CS were included and treated following the same protocol. The association between IABP and the survival of patients at 1 month and 6 months were analyzed separately in SCAI stage C of CS, and stages D and E of CS...

Objective: To investigate the role of caspase recruitment domain protein 9 (CARD9) in airway injury and inflammation of steroid resistant asthma in C57BL/6 mice. Methods: C57BL/6 mice were divided into A group (control group), B group (model group) and C group (dexamethasone treatment group), with 6 mouse in each group using random number table. The mouse asthma model was established in B and C group by subcutaneous injection of ovalbumin (OVA)/complete Freund adjuvant (CFA) in the abdomen and OVA aerosol challenge, the pathological change and cell count in broncho alveolar lavage fluid (BALF) were detected in order to confirm the model as steroid resistant asthma, and the lung tissue inflammatory infiltration was scored...

Objective: To investigate the efficacy and safety of a new endoscopic anastomosis clip in the treatment of defects after endoscopic full-thickness resection (EFTR). Methods: Retrospective cohort study. Fourteen patients [4 males and 10 females, aged (55.9±8.2) years (45-69 years)] with gastric submucosal tumors underwent EFTR at the First Affiliated Hospital of Soochow University were included from December 2018 to January 2021. Patients were divided into new anastomotic clamp group ( n =6) and nylon ring combined with metal clips group ( n =8)...

Objective: To compare the improvement in quality of life (QoL) after implantation of leadless pacemakers (L-PM) with that of conventional pacemakers (C-PM) in patients with slow-onset arrhythmias. Methods: A total of 112 patients who received pacemaker implantation for the first time at Beijing Anzhen Hospital from January 2020 to July 2021 were selected, including 50 leadless pacemakers (L-PM) and 62 conventional pacemakers (C-PM). Clinical baseline data were collected, pacemaker-related complications and SF-36 scores were recorded and followed up at 1, 3, and 12 months post-operatively; SF-36 questionnaires and additional questionnaires were completed to compare the quality of life of the 2 groups; and factors associated with the change in QoL from baseline to 1, 3 and 12 months post-operatively were analyzed using multiple linear regression models...

Objective: To investigate the relationship between different serum potassium levels at admission and discharge and all-cause mortality in patients with acute heart failure (HF). Methods: A total of 2 621 patients with acute HF who were hospitalized in the Heart Failure Center of Fuwai Hospital from October 2008 to October 2017 were analyzed. Patients were divided into three groups according to the different serum potassium levels at admission: hypokalemia with serum potassium<3.5 mmol/L ( n =329), normokalemia with 3...

Objective: To explore the predictive value of controlling nutritional status (CONUT) score and dialysis age for peritoneal dialysis-associated peritonitis (PDAP). Methods: This study was a follow-up study. Patients with end-stage renal disease who received peritoneal dialysis (PD) for the first time in the Department of Nephrology, the Third Affiliated Hospital of Suzhou University from January 2010 to December 2020 were enrolled in the study. Patients were divided into non-peritonitis group, mono group (only once PDAP occurred in one year) and frequent group (twice or more PDAP occurred in one year) according to the occurrence and frequency of PDAP during follow-up...

Objective: To explore the clinical efficacy of a modified no-touch technique (MNTT) in establishing autogenous arteriovenous fistulas (AVF) in hemodialysis patients. Methods: A total of 63 patients with AVF which was first established by MNTT in the Department of Nephrology, Suzhou Science and Technology Town Hospital from January 2021 to August 2022 were retrospectively included. The clinical data, ultrasound evaluation data of AVF, AVF maturity rate and AVF patency rate were collected. Subsequently, the AVF rate of patients in the MNTT group was compared with the patency rate of patients in the conventional operation group in the same hospital from January 2019 to December 2020...

In order to evaluate the efficacy of resecting extramedullary subdural tumors, located in the thoracic spinal canal, via the muscle-pedicle open-door laminoplasty approach, clinical data of fifteen patients with thoracic spinal tumors admitted to the Department of Spinal Surgery in the Affiliated Hospital of Qingdao University from December 2018 to June 2021 were analyzed retrospectively. All patients received surgical treatment to remove the tumors via the muscle-pedicle open-door laminoplasty approach. The clinical data of the patient was recorded...