[Observation on the curative effect of fibula transverse transport technique in the treatment of diabetic foot ulcer].

To investigate the clinical effect of fibula transverse transport technique in the treatment of diabetic foot ulcer. Nine patients (7 males and 2 females) with diabetic foot ulcer were treated with fibula transverse transport technique from September 2017 to September 2020. The mean age was (55±9) years (ranged from 43 to 66 years). In terms of Wagner classification, 2 cases were in grade 2, 5 cases were in grade 3, and the other 2 cases were in grade 4. All of the cases involved ischemic ulcers or ischemic-nerve ulcers. The transcutaneous oxygen pressure (TcPO2) of the dorsal foot of the affected limb was measured, with the ulcer healing and TcPO2 changes recorded at follow-up. All the 9 patients were followed up for (23±12) months (3 to 38 months). It was found that all patients with foot ulcers were cured within (4.2±1.9) months (2 to 8 months), and all the patients obtained limb salvage. Besides, there was no serious complications occurred, such as skin necrosis and needle tract infection. Before the operation, the TcPO2 of the affected foot was (28.6±3.8) mmHg(1 mmHg=0.133 kPa), while it was (35.0±5.6) mmHg three months after operation (P<0.05). The technique of fibula transverse transport can effectively improve the microcirculation function of diabetic foot, and it can promote the healing of the ulcer with few complications.

Associations of four common VDR polymorphisms with rheumatoid arthritis and systemic lupus erythematosus: evidence from a meta-analysis.

Associations of polymorphisms in vitamin D receptor (VDR) with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) have already been explored by many studies. The aim of this meta-analysis was to better clarify associations between polymorphisms in VDR and RA/SLE by combing the results of all relevant studies. Eligible studies were searched from Pubmed, Embase, WOS and CNKI. We used Review Manager to combine the results of eligible studies. Thirty-seven studies were included in this meta-analysis. VDR rs1544410 (recessive comparison: odds ratio (OR) = 1.36, 95% confidence interval (CI) 1.06-1.76; over-dominant comparison: OR = 0.81, 95% CI 0.71-0.93) and rs731236 (over-dominant comparison: OR = 0.77, 95% CI 0.63-0.94) polymorphisms were found to be significantly associated with RA in overall combined analyses. Besides, VDR rs1544410 (dominant comparison: OR = 0.61, 95% CI 0.46-0.82; over-dominant comparison: OR = 1.45, 95% CI 1.16-1.81; allele comparison: OR = 0.75, 95% CI 0.62-0.92), rs2228570 (dominant comparison: OR = 0.58, 95% CI 0.50-0.67; recessive comparison: OR = 1.57, 95% CI 1.21-2.03; allele comparison: OR = 0.69, 95% CI 0.60-0.80) and rs731236 (dominant comparison: OR = 0.69, 95% CI 0.50-0.96; allele comparison: OR = 0.80, 95% CI 0.70-0.90) polymorphisms were also found to be significantly associated with SLE in overall combined analyses. Subgroup analyses revealed that significant associations for VDR polymorphisms and RA/SLE were mainly driven by Asians. Collectively, this meta-analysis proved that VDR rs7975232, rs1544410, rs2228570 and rs731236 polymorphisms may confer susceptibility to RA and SLE, especially for Asians.

Antiferromagnetic Order in Epitaxial FeSe Films on SrTiO_{3}.

Single monolayer FeSe film grown on a Nb-doped SrTiO_{3}(001) substrate shows the highest superconducting transition temperature (T_{C}∼100 K) among the iron-based superconductors (iron pnictides), while the T_{C} value of bulk FeSe is only ∼8 K. Although bulk FeSe does not show antiferromagnetic order, calculations suggest that the parent FeSe/SrTiO_{3} films are antiferromagnetic. Experimentally, because of a lack of a direct probe, the magnetic state of FeSe/SrTiO_{3} films remains mysterious. Here, we report direct evidence of antiferromagnetic order in the parent FeSe/SrTiO_{3} films by the magnetic exchange bias effect measurements. The magnetic blocking temperature is ∼140 K for a single monolayer film. The antiferromagnetic order disappears after electron doping.

Molecular cloning, expression of, and regulation by thyroid-hormone receptor α A in the half-smooth tongue sole Cynoglossus semilaevis during metamorphosis.

To elucidate the effect of thyroid hormone receptor α A (thraa) on metamorphosis, the full length cDNA of half-smooth tongue sole Cynoglossus semilaevis was cloned. The relative gene transcript level of thraa at different development stages was quantified using real-time PCR. Transcription of thraa increased and declined rapidly during metamorphosis. Hyperthyroidism was induced in juveniles and larvae with exposure to T3 and T4, and hypothyroidism with thiourea (TU), 2-mercapto-1-methylimidazole (MMI). thraa mRNA was higher in fish treated for 6 days with MMI than in untreated controls, although inhibited larvae did not complete metamorphosis. The addition of exogenous T4 reversed this effect in the MMI-treated group, but not in the TU-treated group. In situ hybridization revealed progressive tail end of body growth and change during developmental stages, with corresponding changes in thraa expression. This process may be induced by thyroid hormones with thraa as a major mediator. The morphological changes of tip of the tail may be associated with the development of lateral swimming.

[Correlation between morphogical factor of lateral plateau fracture and meniscus injury].

OBJECTIVE: To analyze morphological character of lateral tibial plateau fracture fragment, and its correlation to the presence of a meniscus injury in tibial plateau fractures. METHODS: A total of 79 consecutive patients of the simple lateral tibial plateau fractures from July 2011 to July 2015 were included in this study, with 65 males and 14 females with an average age of (34.3±7.2) years and 22-61 years. According to Schatzker classification, 21 cases were of Type I, 41 cases Type II, and 17 cases Type III. The characteristics of lateral tibial plateau fractures were evaluated by plain X-ray and magnetic resonance imaging (MRI). The type and severity of meniscus injury were diagnosed by MRI scan. Three-dimensional measurements of the lateral fragment width (LFW), the lateral plateau depression (LPD), the coronal angulation of lateral fragment (CALF), and tibial plateau widening (TPW) were measured with Picture Archiving and Communication Systems(PACS) software. The patients with and without meniscus injuries were divided into different groups and analyzed respectively. Comparison of the above measurements between the two groups was analyzed by independent t test. RESULTS: In all the 79 lateral tibial plateau fracture patients, 26 cases (32.9%) of meniscus injuries were detected by MRI. Among all the meniscus injury cases, 3 were of Schatzker I, 16 Schatzker II, and 7 Schatzker III. In meniscus intact group, the average LFW was (22.0±2.8) mm while in meniscus injury group it was (21.3± 3.3) mm (t=-1.008, P=0.317).The average LPD of non meniscus injury group was (5.4±2.8) mm, while in meniscus injury group was (8.7±2.8) mm (t=4.98, P=0.001). The average CALF of the two groups were 9.1°±6.1°and 10.6°± 7.1°, and there was no significant difference between the two groups (t=0.38, P=0.831). The average TPW was (3.0± 1.1) mm, and (4.8±1.7) mm of the two groups. There were significant differences between the two groups (t=5.216, P=0.001). CONCLUSION: There was no obvious correlation between the LFD and meniscus injury. The CALF of lateral tibial plateau fracture had no significant correlation with meniscus injury either. The degree of LPD and TPW may indicate injury of the meniscus in tibial plateau fractures.

Involvement of ligninolytic enzymes in degradation of wheat straw by Trametes trogii.

AIMS: Wheat straw is generated in billions of tons around the world every year and has not been fully used. This study sought to evaluate the delignification capacity and enzyme production of Trametes trogii MT strain and to clarify the changes of structure and chemical composition of wheat straw during the decay process. METHODS AND RESULTS: The results obtained revealed that the T. trogii MT strain has the ability to degrade lignin, cellulose as well as hemicellulose of wheat straw simultaneously. The strain can produce high activities of laccase, manganese peroxidase, xylanase, carboxymethylcellulase and feruloyl esterase but no lignin peroxidases during the decay process of a 60-day incubation period on wheat straw. Scanning electron microscopy observation and infrared spectroscopy analysis showed the lignin and carbohydrate of wheat straw were degraded with no obvious different levels. The low molecular mass fractions collected from the culture of the MT strains grown in wheat straw powder liquid medium showed high Fe(3+) chelating, reducing capacity and hydroxyl radical and hydrogen peroxide generation. CONCLUSIONS: Trametes trogii MT has a complex mechanism to degrade lignocellulose, in addition to the extracellular enzymatic systems, and has great potential as an attractive micro-organism used for the biological degradation of waste straws. SIGNIFICANCE AND IMPACT OF THE STUDY: This study revealed the dynamic changes of the ligninolytic enzymes of T. trogii MT during the degradation of wheat straw, and suggested that the decay patterns of wheat straw by T. trogii MT had some simultaneous type characteristics.

The potential diagnostic accuracy of circulating microRNAs for Alzheimer's disease: A meta-analysis.

BACKGROUND & OBJECTIVE: Alzheimer's disease (AD) is a progressive and irreversible neurodegenerative disease that seriously affects cognitive ability and has become a key public health problem. Many studies have identified the possibility of peripheral blood microRNA as effective non-invasive biomarkers for AD diagnosis, but the results are inconsistent. Therefore, we carried out this meta-analysis to evaluate the diagnostic accuracy of circulating microRNAs in the diagnosis of AD patients. METHODS: We performed a systematic literature search of the following databases: PubMed, EMBASE, Web of Science, Cochrane Library, Wanfang database and China National Knowledge Infrastructure, updated to March 15, 2021. A random effects model was used to pool the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and area under the curve. Meta-regression and subgroup analysis were performed to explore the sources of heterogeneity, and Deeks' funnel plot was used to assess whether there was publication bias. RESULTS: 62 studies from 18 articles were included in this meta-analysis. The pooled sensitivity was 0.82 (95% CI: 0.78-0.85), specificity was 0.80 (95% CI: 0.76-0.83), PLR was 4. 1 (95% CI: 3.4-4.9), NLR was 0.23 (95% CI: 0.19-0.28), DOR was 18 (95% CI: 13-25) and AUC was 0.88 (95% CI: 0.84-0.90). Subgroup analysis shows that the microRNA clusters of plasma type performed a better diagnostic accuracy of AD patients. In addition, publication bias was not found. CONCLUSIONS: Circulating microRNAs can be used as a promising non-invasive biomarker in AD diagnosis.

Sleep disorders in patients with multiple sclerosis in Spain.

OBJECTIVE: This study assesses the presence of sleep disturbances and their relationship with clinical and demographic variables in patients with MS, with a view to establishing correlations between the different variables and the frequency of sleep disturbances. METHODS: The Pittsburgh Sleep Quality Index (PSQI) was used to detect sleep disorders. We contacted patients treated at the MS unit and distributed a questionnaire (PSQI) to 221 patients, receiving 142 usable questionnaires between 8 and 30 September 2019. RESULTS: The prevalence of patients with sleep disturbances in our study was 74.7% (73.7% in women and 76.8% in men). Therefore, sleep disorders are pervasive in patients with MS, with 3 out of 4 patients experiencing them, a higher rate than that observed in the population without the disease. The frequency of sleep disorders gradually increased in line with age. In the 2 age groups analyzed, 44-54 years and 55-68 years, the proportion of moderate and severe sleep disorders was 42.8% and 53.9%, respectively. Moderate and severe sleep disturbances were observed in 27.5%, 44.7%, and 58.3% of patients with Expanded Disability Status Scale scores of 0-3, 3-6, and >6, respectively. CONCLUSION: Our results indicate that sleep disorders are more common in patients with MS than in other populations. Patients with secondary progressive forms of MS more frequently present sleep disturbances, while patients with primary progressive forms report them less frequently. Age and degree of disability were positively correlated with the prevalence and severity of sleep disorders in MS patients.

Incidence and prevalence of multiple sclerosis in China and other Asian countries.

The prevalence of multiple sclerosis (MS) in Asian countries is thought to be lower than in Western countries, with Asian populations presenting 80% less risk of MS than white populations. Incidence and prevalence rates in Asian countries are therefore not well defined and their association with rates in neighboring countries, as well as with ethnic, environmental, and socioeconomic factors, are not well understood. We performed a comprehensive literature review of epidemiological data from China and neighbouring countries to study the frequency of the disease, focusing on prevalence, and the progression over time and the influence of sex-related, environmental, dietary, and sociocultural factors. Prevalence rates in China range between 0.88 cases/100,000 population in 1986 and 5.2 cases/100,000 population in 2013, with a non-significant upwards trend (p = .08). The increase observed in Japan, where figures ranged between 8.1 and 18.6 cases/100,000 population was highly significant (p < .001). Prevalence rates in countries with predominantly white populations are considerably higher and have increased over time, reaching 115 cases/100,000 population in 2015 (r2 = 0.79, p < .0001). In conclusion, the prevalence of MS in China appears to have risen in recent years, although Asian populations (including Chinese and Japanese populations, among others) appear to present less risk than other populations. Within Asia, geographical latitude appears not to be a determining factor for developing MS.

The potential diagnostic accuracy of circulating microRNAs for prostate cancer: A meta-analysis.

OBJECTIVES: This meta-analysis has been conducted to evaluate the diagnostic accuracy of circulating microRNAs for the early diagnosis of prostate cancer (PCA). METHODS: A systematic literature search was performed (updated to February 18, 2021) in PubMed, EMBASE, Web of Science, Cochrane Library, Wanfang database and China National Knowledge Infrastructure (CNKI) to identify eligible studies. The pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under curve (AUC) of the summary receiver-operating characteristic (SROC) curve were calculated for both overall and subgroup analysis. The meta-regression and subgroup analysis were performed to explore heterogeneity and Deeks' funnel plot was used to assess publication bias. RESULTS: One hundred nineteen studies from 33 articles owned 8703 PCA patients and 4914 controls were included in our meta-analysis. The overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and area under the curve were 0.79, 0.81, 4.1, 0.26, 16 and 0.87, respectively. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve of miR-21 in diagnosis of PCA were 0.86, 0.90, 8.3, 0.16, 52 and 0.94, respectively. Subgroup analysis suggested that the upregulated miRNA of serum type with large sample size could carry out a better diagnostic accuracy of PCA patients. Moreover, publication bias was not found. CONCLUSIONS: Circulating microRNA, especially miR-21, can be used as a promising noninvasive biomarker in the early diagnosis of PCA.

[Application of internal carotid artery stent in skull base surgery].

Objective: To report the experience of the application of internal carotid artery stent in skull base surgery, and to clarify the important role of internal carotid artery stent in skull base surgery. Methods: A retrospective study of 22 cases with skull base neoplasms implanted with internal carotid artery stents in the Department of ENT Head and Neck Surgery at the Sixth People's Hospital affiliated with Shanghai Jiao Tong University between July 2019 and January 2021 was conducted. Among them, 17 were male and 5 were female, aged between 33 and 75 years. There were 5 cases on the left, 16 cases on the right, and 1 case on both sides. Of these, there were 4 cases of jugular paraganglioma, 1 case of chondrosarcoma in the jugular foramen, 1 case of carotid body paraganglioma, and 16 cases of nasopharyngeal carcinoma after radiotherapy. Results: The degree of internal carotid artery erosion was assessed by computed tomography angiography (CTA), magnetic resonance imaging and digital subtraction angiography (DSA) images in 22 patients before surgery. It was found that the internal carotid artery was involved to varying degrees in all patients, so internal carotid artery stents were implanted before surgery. Tumor tissue was found to surround the internal carotid artery to varying degrees. Total or subtotal tumor resection was performed in all patients, and no intraoperative and postoperative complications occurred. The postoperative follow-up was 5 months to 2 years, and all patients had no complications such as spontaneous bleeding and pseudo aneurysm. There were no signs of stenosis or occlusion of the internal carotid artery stent segment in all cases. Conclusions: For patients with skull base tumors, preoperative imaging indicates the limited involvement of the internal carotid artery, and internal carotid artery stent implantation before surgery is a safe and effective treatment.

The social and occupational consequences of the COVID-19 pandemic among patients with multiple sclerosis in three distinct populations: A web-based cross-sectional survey.

Background: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the disease COVID-19, has caused a pandemic that has rapidly affected the whole world and caused a significant threat to public health. The aim of this study was to investigate and analyze the social and occupational effects of the COVID-19 pandemic on patients with multiple sclerosis (MS) in three different countries: China, Spain, and Cuba. Methods: A cross-sectional survey was designed to assess the social and occupational effects of the COVID-19 pandemic in MS patients in these three countries, using a 25-item anonymous online questionnaire, structured into three sections. Quantitative data are expressed as mean (standard deviation), and quantitative data as absolute frequency and percentage. Results: A total of 361 participants responded to the questionnaire: 194 from China, 104 from Spain, and 63 from Cuba. We found no cases of COVID-19 among Chinese patients with MS, and few cases in Spain and Cuba. Respondents reported different levels of impact on relationships with friends, family, and colleagues, and patients in all three countries described increased use of digital or social media platforms. Spanish patients reported a significantly less negative impact than those in Cuba and China. Mental and cognitive effects were similar in all three countries, although China seemed to have a better situation. We also found that the time spent exercising decreased at specific points during the pandemic, but with few changes in dietary habits. Patients reported little or no change in their means of transport in all three countries. Most patients in all three countries reported little or no physical deterioration, especially in Chinese patients (82.47%), compared to the Spanish (70.20%) and Cuban respondents (73.02%). In general, patients from all three countries demonstrated confidence in overcoming the COVID-19 pandemic, although to a lesser extent among Spanish respondents. Conclusions: During the pandemic, family support was more effective in China than in Cuba and Spain. Neither COVID-19 infections nor the number of MS relapses increased significantly during lockdown in any of the three countries. Regarding their economic situation, Spanish MS patients reported a significantly less severe negative impact than those in Cuba and China. Patients from all three countries used digital or social media platforms more frequently, probably to maintain personal relationships. Chinese and Cuban respondents were more confident of the control of the pandemic than the Spanish, who were more pessimistic.

Introducción: El nuevo coronavirus de tipo 2, causante del síndrome respiratorio agudo severo o COVID-19, se ha expandido rápidamente a nivel mundial, convirtiéndose en una grave amenaza para la salud pública en forma de pandemia. El objetivo de este estudio es analizar los efectos sociolaborales de la pandemia de COVID-19 en pacientes con esclerosis múltiple (EM) en 3 países diferentes (China, España y Cuba). Métodos: Diseñamos un estudio transversal para valorar los efectos sociolaborales de la pandemia de COVID-19 en pacientes con EM procedentes de China, España y Cuba mediante un cuestionario digital de 25 preguntas divididas en 3 apartados. Los datos cuantitativos se expresan como medias y desviaciones estándar, mientras que los datos cualitativos se expresan mediante valores y porcentajes. Resultados: Un total de 361 pacientes respondieron al cuestionario (194 de China, 104 de España y 63 de Cuba). No encontramos ningún paciente chino con EM que hubiera padecido COVID-19, y los casos diagnosticados en España y Cuba fueron muy infrecuentes. A raíz de la pandemia, se observaron cambios en las relaciones con amigos, familiares y compañeros; además, los pacientes con EM usaron plataformas digitales y redes sociales con más frecuencia en los 3 países. El impacto negativo fue significativamente menor en España que en Cuba o China. Los efectos mentales y cognitivos de la pandemia fueron similares en los 3 países, aunque parece que la situación previa era mejor en China. Igualmente, observamos que el tiempo dedicado al ejercicio se redujo en momentos específicos durante la pandemia. Por el contrario, no se detectaron grandes cambios en los hábitos alimentarios. Los pacientes de los 3 países consideraron que no se produjeron cambios en su medio de transporte, o que estos fueron escasos. La mayoría de los pacientes ha experimentado poco o ningún deterioro físico, particularmente los pacientes chinos (82,47%) en comparación con los españoles (70,20%) y cubanos (73,02%). En líneas generales, todos los pacientes se mostraron esperanzados en superar la pandemia, aunque los pacientes españoles en menor grado. Conclusiones: Durante la pandemia, el apoyo familiar fue más importante en China que en Cuba o España. En ninguno de los 3 países se observó un aumento significativo en el número de casos de COVID-19 ni de brotes o recaídas durante el periodo de confinamiento. En términos económicos, los pacientes con EM españoles sufrieron un impacto negativo significativamente menor que los cubanos y chinos. Todos los pacientes usaron plataformas digitales o redes sociales con más frecuencia, probablemente con el fin de mantener relaciones personales. Los pacientes chinos y cubanos mostraron mayor confianza en el control de la pandemia que los españoles, que resultaron ser más pesimistas.

The potential diagnostic accuracy of circulating microRNAs for Alzheimer's disease: A meta-analysis.

BACKGROUND & OBJECTIVE: Alzheimer's disease (AD) is a progressive and irreversible neurodegenerative disease that seriously affects cognitive ability and has become a key public health problem. Many studies have identified the possibility of peripheral blood microRNA as effective non-invasive biomarkers for AD diagnosis, but the results are inconsistent. Therefore, we carried out this meta-analysis to evaluate the diagnostic accuracy of circulating microRNAs in the diagnosis of AD patients. METHODS: We performed a systematic literature search of the following databases: PubMed, EMBASE, Web of Science, Cochrane Library, Wanfang database and China National Knowledge Infrastructure, updated to March 15, 2021. A random effects model was used to pool the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and area under the curve. Meta-regression and subgroup analysis were performed to explore the sources of heterogeneity, and Deeks' funnel plot was used to assess whether there was publication bias. RESULTS: 62 studies from 18 articles were included in this meta-analysis. The pooled sensitivity was 0.82 (95% CI: 0.78-0.85), specificity was 0.80 (95% CI: 0.76-0.83), PLR was 4. 1 (95% CI: 3.4-4.9), NLR was 0.23 (95% CI: 0.19-0.28), DOR was 18 (95% CI: 13-25) and AUC was 0.88 (95% CI: 0.84-0.90). Subgroup analysis shows that the microRNA clusters of plasma type performed a better diagnostic accuracy of AD patients. In addition, publication bias was not found. CONCLUSIONS: Circulating microRNAs can be used as a promising non-invasive biomarker in AD diagnosis.

[Diagnosis and surgical treatment of sinonasal phosphaturic mesenchymal tumor].

Objective: To investigate the diagnosis and surgical treatment of sinonasal phosphaturic mesenchymal tumor (PMT). Methods: The medical records of nine patients who had been diagnosed as sinonasal PMT in Department of Otorhinolaryngology Head and Neck Surgery, Shanghai JiaoTong University Affiliated Sixth People's Hospital between January 2015 and May 2020 were collected, including 4 males and 5 females, ranging from 36 to 59 years. The patient's previous history, clinical manifestations, imaging findings, laboratory results, surgical procedure, pathological results and postoperative follow-up data were analyzed by descriptive statistical analysis. Results: All patients presented hypophosphatemia and tumor-induced osteomalacia (TIO) with a disease course of 1 to 19 years. The imaging examination and intraoperative findings identified two cases with peripheral tissue infiltration, two cases with contralateral nasal cavity invasion, and one case with intracranial invasion. Five patients underwent unilateral endoscopic resection while two patients underwent bilateral endoscopic resection, and the remaining two patients underwent unilateral transorbital ethmoid artery ligation plus endoscopic tumor resection and endoscopic combined with transfrontal tumor resection (n=1 each). Expect for one case developed recurrence and intracranial involvement, the other patients achieved clinical remission and no recurrence was observed during the six-month follow-up. Conclusions: The diagnosis of sinonasal PMT needs combination of clinical manifestation, imaging, and pathological findings. Complete surgical excision and long-term postoperative follow-up are imperative.

Sleep disorders in patients with multiple sclerosis in Spain.

OBJECTIVE: This study assesses the presence of sleep disturbances and their relationship with clinical and demographic variables in patients with MS, with a view to establishing correlations between the different variables and the frequency of sleep disturbances. METHODS: The Pittsburgh Sleep Quality Index (PSQI) was used to detect sleep disorders. We contacted patients treated at the MS unit and distributed a questionnaire (PSQI) to 221 patients, receiving 142 usable questionnaires between 8 and 30 September 2019. RESULTS: The prevalence of patients with sleep disturbances in our study was 74.7% (73.7% in women and 76.8% in men). Therefore, sleep disorders are pervasive in patients with MS, with 3 out of 4 patients experiencing them, a higher rate than that observed in the population without the disease. The frequency of sleep disorders gradually increased in line with age. In the 2 age groups analyzed, 44-54 years and 55-68 years, the proportion of moderate and severe sleep disorders was 42.8% and 53.9%, respectively. Moderate and severe sleep disturbances were observed in 27.5%, 44.7%, and 58.3% of patients with Expanded Disability Status Scale scores of 0-3, 3-6, and >6, respectively. CONCLUSION: Our results indicate that sleep disorders are more common in patients with MS than in other populations. Patients with secondary progressive forms of MS more frequently present sleep disturbances, while patients with primary progressive forms report them less frequently. Age and degree of disability were positively correlated with the prevalence and severity of sleep disorders in MS patients.

Social and professional consequences of COVID-19 lockdown in patients with multiple sclerosis from two very different populations. / Consecuencias sociolaborales del confinamiento por la COVID-19 en pacientes con esclerosis múltiple en dos poblaciones muy diferentes.

The global lockdown measures implemented due to the COVID-19 pandemic have nearly always had negative consequences for patients with multiple sclerosis (MS). OBJECTIVE: We compared the social and professional effects of confinement on patients with MS in 2 very different populations, from Spain and China. METHODS: Questionnaires were administered to a group of patients with MS who consulted at the MS unit of Vithas hospital (DINAC Foundation) in Seville, and patients with MS attended in several provinces of China in April 2020, with the aim of analysing the differences and similarities between populations in the social and professional effects of confinement. To this end, a database was created and subsequently analysed. RESULTS: The Chinese population includes a higher proportion of younger patients and no differences were identified regarding sex. Most of the variables studied behaved in the same way in both patient populations. Spanish patients presented a lesser impact (30.7%) on their socio-economic situation than Chinese patients (44%) (P < .05). There were no significant differences between populations in the remaining variables. Social networks were widely used in the majority of patients from both populations. CONCLUSIONS: The social and professional consequences of the pandemic were very similar in both groups; the use of social networks and family support was also similar. Spanish patients seem to present greater economic stability, perhaps due to the social support they receive.

[Sensitivity and specificity of nucleic acid testing in close contacts of COVID-19 cases in Guangzhou].

Objective: To analyze the sensitivity and specificity of SARS-CoV-2 nucleic acid testing in 20 348 close contacts of COVID-19 cases in different prevention and control stages in Guangzhou and to provide scientific evidence for optimizing epidemic response strategies. Methods: A total of 20 348 close contacts of COVID-19 cases in Guangzhou were traced between February 21 and September 22,2020. All the close contacts were tested for the nucleic acid of SARS-CoV-2. The sensitivity and specificity of nucleic acid testing and diagnosis in the different prevention and control stages were compared. Results: In 20 348 close contacts, 12 462 were males (61.24%), the median (P25,P75) of age of them was 31.0 years (23.0,43.0), the median number (P25,P75) of nucleic acid testing for them was 2.0 (1.0,3.0), and the median (P25,P75) of their quarantine days was 12.0 (8.0,13.0) days, respectively. A total of 256 COVID-19 cases were confirmed in the close contacts after seven nucleic acid tests. In the 1st, 2nd, 3rd and 7th nucleic acid testing, the sensitivity and specificity were 69.14% and 99.99% (177 cases confirmed), 89.84% and 99.99% (230 cases confirmed), 97.27% and 99.99% (249 cases confirmed), and 100.00% and 99.98%, respectively. In the three stages of COVID-19 prevention and control in China: domestic case stage, imported case stage, and imported case associated local epidemic stage, the sensitivity of the 1st nucleic acid testing was 70.68%, 68.00% and 67.35%, and the specificity was 99.98%, 100.00% and 100.00%, respectively. Conclusions: The sensitivity of nucleic acid testing in the close contacts at the different stages were consistent with slight decrease, which might be related to the increased proportion of asymptomatic infections in the late stage of epidemic prevention and control with COVID-19 in Guangzhou. It is suggested to give three nucleic acid tests to improve the sensitivity and reduce false negative risk.