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Parkinson's disease(PD)and multiple system atrophy(MSA)are two common Parkinsonian syndromes with overlapping clinical manifestations, and clinical differential diagnosis is difficult.Lower urinary tract symptoms are one of the common non-motor symptoms of the two diseases.The incidence of lower urinary tract symptoms in MSA is higher, the onset is earlier, and the micturition period is more prominent.The urinary dysfunction in patients with PD is mainly caused by the central mechanism, leading to overactive bladder.MSA has more extensive lesions with both central and peripheral involvement, leading to overactive bladder and severe voiding dysfunction.Urodynamics can be used to evaluate bladder and urethral function.MSA has more prominent weak detrusor activity, residual urine volume, and early changes of urethral sphincter.The treatment of lower urinary tract symptoms in patients with PD is mainly based on anticholinergic drugs to improve overactive bladder, while in MSA patients with increased residual urine volume, intermittent catheterization is the main method to improve lower urinary tract symptoms.This article reviewed the epidemiology, pathological mechanism, urodynamics and treatment of lower urinary tract symptoms of the two diseases, so as to assist in their differential diagnosis and treatment.
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Objective:To compare the clinical effects of different approaches of unilateral thyroid lobectomy in the treatment of papillary thyroid microcarcinoma (PTMC) .Methods:From Jun. 2019 to Jun. 2022, 70 patients with PTMC from Thyroid and Breast Surgery Department of Taihe Hospital and Dongfeng General Hospital were selected for prospective study. They were divided into transoral group with 35 cases according to random number table method. Trans-oral endoscopic thyroidectomy (TOET) was adopted in 11 males and 24 females, aging (40.71±5.09) years old, ranging from 23 to 60 years old; 35 cases in the trans-axillary group, using trans-axillary approach Endoscopic thyroidectomy by areola approach (ETAA) including 13 males and 22 females, aging (40.25±5.06) years old, ranging from 24 to 59 years old. Perioperative indicators, inflammatory factors, and stress indicators were recorded in the two groups. The level and complications were followed up for 3 months to evaluate the aesthetics of surgical incisions. The comparison of measurement data between groups was performed by independent t test, and the comparison of count data was conducted by χ2 test. Results:The number of lymph nodes dissected and intraoperative blood loss in the oral cavity group were significantly better than those in the axillary group [ (8.71±0.93) vs (6.85±0.82), (23.05±3.51) ml vs (26.14±3.96) ml] ( t=8.88, 3.46, P<0.05) ; The first day after operation, serum norepinephrine (NE) and cortisol (Cor) in the oral cavity group were significantly lower than those in the axillary group [ (275.31±30.41) ng/L vs (300.22±33.25) ng/L, (180.25±19.75) nmol/L vs (205.36±22.41) nmol/L] ( t=3.27, 4.97, P<0.05) ; The first day after operation, the levels of serum C-reactive protein (CRP) and interleukin-6 (IL-6) in the oral cavity group were significantly lower than those in the axillary group [ (7.05±0.86) mg/L vs (8.74±1.02) mg/L, (4.33±0.62) pg/L vs (6.45±0.81) pg/L] ( t=7.49, 12.30, P<0.05) ; there was no significant difference in the incidence of complications between the groups ( P>0.05) ; Three months postoperatively, the aesthetics of the incision in the oral cavity group (94.29%) was significantly higher than that in the axillary group (77.14%) ( χ2=4.20, P<0.05) . Conclusion:When unilateral thyroid lobectomy is performed for papillary thyroid microcarcinoma, the transoral vestibular approach is less invasive than the transaxillary approach, and the effect of lymph node dissection is better, which is beneficial to reduce the surgical stress response of patients, and the aesthetics of the surgical incision are higher.
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Objective:To explore the interaction effectiveness of residence and social support on physical function for older adults.Methods:Using multistage sampling method, the older adults in 9 provinces were chosen to investigate from January 2022 to January 2023 by using general information questionnaire and Short Physical Performance Battery.Binary Logistic regression analysis was used to explore the independent effectiveness of social support and residence category on physical function.The additive and multiplicative models were used to analyze the interactions between above two factors.Results:A total of 23 922 older adults were investigated.And 18 719(78.3%)older adults had poor physical function.There were significant independent effect of social support and residence category on physical function of older adults( P<0.001). Besides, the results showed that residence category and social support had a significant multiplicative interaction on physical function( OR=0.763, 95% CI: 0.615-0.947, P=0.014). The crossover analysis showed that older adults living in rural as well as lack of social support had the highest probability of impaired physical function( OR=1.521, 95% CI: 1.308-1.769, P<0.001). But there was no difference found in additive interaction. Conclusions:An interaction effect was found in rural living and lack of social support.Older adults living in rural as well as lack of social support have a higher risk of impaired physical function.
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Objective:To investigate the incidence of various non-motor symptoms (NMS) in early stage of Parkinson′s disease (PD) patients and the differences between the body-first and brain-first subtypes.Methods:A total of 121 patients with PD (Hoehn-Yahr stage 1-2) were recruited from PD Clinic, Department of Neurology, Beijing Hospital from January 2012 to January 2015. The general information and clinical features of the patients were collected. The minimal diagnostic criteria of parasomnias described in the International Classification of Sleep Disorders-Revised were used to diagnose rapid eye movement sleep behavior disorder (RBD).According to the sequence of RBD and motor symptoms, the patients were divided into 2 groups: body-first subtype and brain-first subtype. NMS was evaluated by the Non-Motor Symptom Questionnaire (NMSQuest). The clinical features and the incidence of various NMS were compared between the 2 groups. The Unified Parkinson′s Disease Rating Scale (UPDRS) was used to evaluate the severity of the disease, and its third part (UPDRS-Ⅲ) was used to evaluate the motor function of the patients. Hamilton Rating Scale for Depression (HAMD) and Hamilton Rating Scale for Anxiety (HAMA) were used to evaluate the depression and anxiety status of the patients. The sleep status of patients was assessed by Parkinson′s Disease Sleep Scale (PDSS). The quality of life of the patients was assessed by 39-item Parkinson′s Disease Questionnaire (PDQ-39).Results:Of all the patients, 49.59% (60/121) had the body-first subtype and 50.41% (61/121) had the brain-first subtype of PD. There was no significant difference in UPDRS-Ⅲ score between the 2 groups. The average number of NMS in all PD patients was 10.97±4.88. Body-first subtype patients had higher NMS incidence than brain-first subtype in difficulty in swallowing [46.7% (28/60) vs 23.0% (14/61), χ 2=7.507, P=0.006], nausea and vomiting [16.7% (10/60) vs 3.3% (2/61), χ 2=6.069, P=0.014], constipation [85.0% (51/60) vs 55.7% (34/61), χ 2=12.393, P<0.001], fecal incontinence [8.3% (5/60) vs 0 (0/61), χ 2=5.302, P=0.021], difficulty in remembering recent events [58.3% (35/60) vs 32.8% (20/61), χ 2=7.962, P=0.005], loss of interest [43.3% (26/60) vs 24.6% (15/61), χ 2=4.743, P=0.029], inattention [45.0% (27/60) vs 19.7% (12/61), χ 2=8.884, P=0.003], depression [55.0% (33/60) vs 34.4% (21/61), χ 2=5.181, P=0.023], intense vivid dreams [73.3% (44/60) vs 39.3% (24/61), χ 2=14.196, P<0.001] and restless legs [53.3% (32/60) vs 27.9% (17/61), χ 2=8.140, P=0.004]. The differences were significant. Body-first subtype and NMSQuest ( r=-0.489, P<0.001), UPDRS ( r=-0.189, P=0.038), HAMD ( r=-0.231, P=0.011), HAMA ( r=-0.298, P=0.001) and PDQ-39 scores ( r=-0.276, P=0.002) were negatively correlated. Body-first subtype and PDSS score was positively correlated. NMSQuest (Δ R2=0.265, P<0.001) was the main determinant of PDQ-39 score. Conclusions:PD patients are accompanied by various NMS, which is a major factor affecting the quality of life. Compared with brain-first subtype, body-first subtype might have more NMS burden and higher incidence rate in most NMS in early PD patients.
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Objective:To investigate the characteristics and clinical related factors of Parkinson′s disease (PD) patients with subjective cognitive decline (SCD).Methods:Ninety-nine PD patients with normal cognitive function enrolled in Beijing Hospital from January to December 2018 were collected for the study. Patients with PD were divided into groups with ( n=57) and without ( n=42) SCD using the first question in Part 1 of the Unified Parkinson′s Disease Rating Scale (UPDRS). All patients were assessed by Montreal Cognitive Assessment (MoCA), modified Hoehn-Yahr grading, UPDRS, Hamilton Rating Scale for Depression (HAMD), Hamilton Rating Scale for Anxiety (HAMA), Parkinson′s Disease Sleep Scale, Ability of Daily Living Scale and 39-item Parkinson′s Disease Questionnaire (PDQ-39). Levodopa equivalent dose conversion was performed for patients taking anti-PD drugs. Patients′ self-reported years of formal education were collected. Results:The proportion of PD with SCD in this group was 57.58% (57/99). There were statistically significant differences in MoCA [28.00 (27.00, 29.00) vs 28.00 (27.00, 29.00) ,Z=-2.28, P=0.023], HAMD [6.00 (5.00, 8.50) vs 5.00 (2.00, 8.00), Z=-2.23, P=0.026], HAMA [7.00 (6.00, 11.00) vs 6.00 (3.00, 8.25) , Z=-2.70, P=0.007], PDQ-39-emotional health [2.00 (0, 5.00) vs 1.00 (0, 3.00), Z=-2.03, P=0.042] and PDQ-39-cognitive scores [4.00 (2.00, 5.00) vs 2.00 (0, 4.00), Z=-3.42, P=0.001] between PD with and without SCD groups. SCD was correlated with MoCA ( r=-0.23, P=0.022), HAMD ( r=0.23, P=0.025) and HAMA ( r=0.27, P=0.006) scores to varying degrees. When controlling for HAMD and HAMA scores, the correlation between SCD and MoCA scores ( r′=-0.18, P=0.084) was no longer existed. Conclusions:SCD is common in PD patients with normal cognitive function and is associated with poorer cognitive performance and more severe symptoms of depression and anxiety. In this group of patients, the relationship between SCD and affective symptoms may be greater than that of objective overall cognitive function, which is worthy of further studies.
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Total anomalous pulmonary venous connection is a rare congenital heart disease. The treatment of the disease itself and postoperative pulmonary vein obstruction(PVO)is a difficult problem for cardiac surgeons. The purpose of this paper is to summarize the progress of research on PVO after TAPVC repair in recent years at home and abroad, and to describe its definition, mechanism, pathological typing, clinical manifestations, diagnosis, and risk factors, in order to be able to correctly understand PVO, provide opinions for choosing reasonable treatment and reduce the occurrence of postoperative PVO.
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The novel coronavirus SARS-CoV-2, which in humans leads to the disease COVID-19, has caused global disruption and more than 1.5 million fatalities since it first emerged in late 2019. As we write, infection rates are currently at their highest point globally and are rising extremely rapidly in some areas due to more infectious variants. The primary viral target is the cellular receptor angiotensin-converting enzyme-2 (ACE2). Recent sequence analyses of the ACE2 gene predicts that many nonhuman primates are also likely to be highly susceptible to infection. However, the anticipated risk is not equal across the Order. Furthermore, some taxonomic groups show high ACE2 amino acid conservation, while others exhibit high variability at this locus. As an example of the latter, analyses of strepsirrhine primate ACE2 sequences to date indicate large variation among lemurs and lorises compared to other primate clades despite low sampling effort. Here, we report ACE2 gene and protein sequences for 71 individual strepsirrhines, spanning 51 species and 19 genera. Our study reinforces previous results and finds additional variability in other strepsirrhine species, and suggests several clades of lemurs have high potential susceptibility to SARS-CoV-2 infection. Troublingly, some species, including the rare and Endangered aye-aye (Daubentonia madagascariensis), as well as those in the genera Avahi and Propithecus, may be at high risk. Given that lemurs are endemic to Madagascar and among the primates at highest risk of extinction globally, further understanding of the potential threat of COVID-19 to their health should be a conservation priority. All feasible actions should be taken to limit their exposure to SARS-CoV-2.
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Objective:To investigate the clinical features and associated chronic pain in corticobasal syndrome (CBS).Methods:Clinical data of 8 patients diagnosed as probable CBS or possible CBS admitted to Beijing Hospital during January 2010 to June 2020 were retrospectively analyzed. The clinical information included sex, age, course of disease, chief complaint, neurological examination, blood biochemistry, tumor marker, infection and other laboratory tests; the neuropsychological evaluation included Mini-Mental State Examination (MMSE) scale and Hamilton Depression Scale (HAMD); the imaging studies included cranial magnetic resonance imaging (MRI) and/or 18F-Fluorodeoxyglucose positron emission tomography ( 18F-FDG PET). Results:The main clinical manifestations were asymmetrical movement disorders, including rigidity, tremor, myoclonus and abnormalities in posture and gait. Patients showed poor response to levodopa treatment. Among 8 patients, 7 had apraxia, 5 patients had alien hand, and 5 patients had various degrees of cognitive dysfunction. The cranial MRI demonstrated mild cerebral atrophy which was slightly more severe in the contralateral side of the initially affected limb in 7 of the 8 patients. The 18F-FDG PET scan revealed asymmetric decreased metabolism in the frontal, parietal, temporal, and occipital lobe, as well as in basal ganglia, which was more severe in the contralateral side of the initially affected limb in 5 of the 8 patients. Six of the 8 patients were associated with pain, including dystonic pain in 3 patients, neuropathic pain in 1 patient, musculoskeletal pain in 1 patient, and unexplained pain in 1 patient. Pain was the onset symptom in 1 patient and pain was relieved by taking levodopa in another patient. Conclusions:CBS is characterized by asymmetric dyskinesia and cognitive impairment, and often associated with apraxia, cortical sensory deficits, and alien limb. The MRI and PET are helpful for CBS diagnosis. Pain may be one of the common non-motor symptoms in CBS.
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The COVID-19 pandemic caused by SARS-CoV-2 has brought about an unprecedented crisis, taking a heavy toll on human health, lives as well as the global economy. There are no SARS-CoV-2-specific treatments or vaccines available due to the novelty of this virus. Hence, rapid development of effective vaccines against SARS-CoV-2 is urgently needed. Here we developed a pilot-scale production of a purified inactivated SARS-CoV-2 virus vaccine candidate (PiCoVacc), which induced SARS-CoV-2-specific neutralizing antibodies in mice, rats and non-human primates. These antibodies potently neutralized 10 representative SARS-CoV-2 strains, indicative of a possible broader neutralizing ability against SARS-CoV-2 strains circulating worldwide. Immunization with two different doses (3g or 6 g per dose) provided partial or complete protection in macaques against SARS-CoV-2 challenge, respectively, without any antibody-dependent enhancement of infection. Systematic evaluation of PiCoVacc via monitoring clinical signs, hematological and biochemical index, and histophathological analysis in macaques suggests that it is safe. These data support the rapid clinical development of SARS-CoV-2 vaccines for humans. One Sentence SummaryA purified inactivated SARS-CoV-2 virus vaccine candidate (PiCoVacc) confers complete protection in non-human primates against SARS-CoV-2 strains circulating worldwide by eliciting potent humoral responses devoid of immunopathology
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Objective:To explore the clinical value of mean platelet volume/platelet count ratio(MPV/PLT)in predicting short-term prognosis of elderly patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:A total of 226 elderly patients with AECOPD admitted to our hospital from January 2017 to January 2019 were retrospectively enrolled as research subjects.All cases were divided into the survival group(n=175)and the death group(n=51), based on prognosis 28-day after admission.General data and laboratory test results were compared between the two groups.The relevant factors for death were analyzed by the Logistic regression equation.The receiver operating characteristic(ROC)curve was used to evaluate the prognostic value of MPV/PLT, and the Kaplan-Meier survival curve was drawn according to the cut-off.Methods:Compared with the survival group, Acute Physiology and Chronic Health Status Evaluation(APACHEⅡ)score, levels of procalcitonin(PCT), high-sensitivity C-reactive protein(hs-CRP), creatinine, neutrophil count(NEU), lymphocyte count(LYM)and MPV were elevated, and levels of albumin and PLT decreased in the death group( P<0.05). Hospital stay lengths and costs were higher in the death group than in the survival group( P<0.05). The level of MPV/PLT was higher in the death group than in the survival group(0.065±0.016 vs.0.054±0.013, t=5.036, P<0.01). Multivariate Logistic regression showed that MPV/PLT was an independent risk factor for recent death( OR=2.331, 95% CI: 1.772-8.224, P<0.01). ROC curve analysis showed that the area under the curve(AUC)of MPV/PLT was 0.829, the sensitivity was 83.41%, the specificity was 82.80%, and the cut-off was 0.061.Optimal cut-off value analysis showed that APACHEⅡ score, PCT and hs-CRP levels and mortality were higher in patients with MPV/PLT≥0.061 than in patients with MPV/PLT<0.061( P<0.05). The Kaplan Meier survival curve showed that the cumulative survival rate was lower in those with MPV/PLT≥0.061 than in those with MPV/PLT<0.061( Log- rank=6.323, P<0.05). Conclusions:The increase of MPV/PLT may be an independent risk factor for recent death in elderly patients with AECOPD and has good clinical value in predicting poor prognosis.
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@#Objective To explore the predictive value of myocardial vitality in the improvement of cardiac function after coronary artery bypass grafting (CABG) in patients with ischemic heart failure. Methods From December 8, 2015 to November 12, 2018, 46 patients with ischemic heart failure who underwent CABG operation alone were collected retrospectively. There were 41 males and 5 females with an average age of 60.4±8.0 years. The myocardial vitality and number of different types of myocardium were measured. The clinical data of patients in the left ventricular ejection fraction (LVEF) improvement group (≥5%) and non-improvement group (<5%) were compared and analyzed. The correlation between each index and LVEF improvement was analyzed by logistic multivariate regression analysis, and the boundary value of hibernating myocardium between LVEF improvement and non-improvement was obtained by receiver operating characteristic (ROC) curve. Results There were significant differences in the number of hibernating myocardium (15.0%±12.3% vs. 4.3%±4.5%, P=0.000), the number of normal myocardium (74.7%±13.7% vs. 82.4%±8.6%, P=0.027), and cardiac function classification (NYHA) development (−0.7±0.7 vs. −0.3±0.5, P=0.047) between the two groups, but there was no significant difference in other indexes between the two groups (P>0.05). Logistic regression analysis showed that the number of hibernating myocardium was an independent factor affecting the improvement of LVEF after CABG in patients with ischemic heart failure (OR=1.366, 95%CI 1.033-1.807, P=0.029). The ROC curve showed that the threshold value, sensitivity and specificity of hibernating myocardium were 15.0%, 43.8% and 100.0%, respectively. Conclusion The percentage of hibernating myocardium to left ventricular wall area ≥15.0% can accurately predict the improvement of LVEF in patients with ischemic heart failure after CABG. Preoperative myocardial vitality assessment has important diagnostic value in predicting the improvement of cardiac function in patients with ischemic heart failure after simple CABG.
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Objective To investigate the relationship between educational level and cognitive function in patients with non?dementia Parkinson′s disease (PD). Methods Forty non?dementia PD patients and forty healthy controls (HC) enrolled in Beijing Hospital from January to December 2018 were collected for the study. The two groups were divided into three subgroups (low, medium and high) according to their years of education. HC group and PD group were matched in age, gender, years of education, and Mini?Mental State Examination score. All subjects underwent three tests of executive function: the Trail Making Test (TMT?A and TMT?B), the Verbal Fluency Test (VFT) and the WAIS digital span test (forward and backward). Results There were statistically significant differences in the error number of TMT?A (0.00 (0.00, 1.00),0.00 (0.00, 0.00), 0.00 (0.00, 0.00); χ2=10.11, P=0.006), the time of TMT?B ((81.17±36.83) s, (52.10 ± 27.88) s, (47.72 ± 23.18) s; F=5.16, P=0.011), the error number of TMT?B (3.00 (0.00, 4.00), 1.00 (0.00, 3.50), 0.00 (0.00, 0.00); χ2=7.16, P=0.028) and the number of backward (3.17±0.72, 3.50±1.08, 4.00± 0.77; F=3.68, P=0.035) among the three subgroups of PD group. There were statistically significant differences between the PD group and the HC group in the time of TMT?A (PD: (64.03±15.96) s, HC: (53.00± 19.50) s; t=2.77, P=0.007), the time (PD: (58.85±31.91) s, HC: (37.35±19.42) s; t=3.64, P=0.001) and error number (PD: 0 (0, 4), HC: 0 (0, 0); Z=-3.15, P=0.002) of TMT?B, the number of backward (PD: 3.63±0.90, HC: 4.98±1.21; t=-5.67, P=0.000) and VFT (PD: 14.48±3.37, HC: 16.15±2.03; t=-2.69, P=0.009). In the low and medium education level subgroups, the PD group showed worse results in three tests of executive function than the HC group, some with statistically significant differences (P<0.05). There was no statistically significant difference in the results of three tests of executive function between two subgroups of high education in the PD group and the HC group (P>0.05). Conclusions Executive functions of non?dementia PD patients are impaired. Education level may have a certain impact on cognitive function of PD patients.
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Objective@#To investigate the relationship between educational level and cognitive function in patients with non-dementia Parkinson′s disease (PD).@*Methods@#Forty non-dementia PD patients and forty healthy controls (HC) enrolled in Beijing Hospital from January to December 2018 were collected for the study. The two groups were divided into three subgroups (low, medium and high) according to their years of education. HC group and PD group were matched in age, gender, years of education, and Mini-Mental State Examination score. All subjects underwent three tests of executive function: the Trail Making Test (TMT-A and TMT-B), the Verbal Fluency Test (VFT) and the WAIS digital span test (forward and backward).@*Results@#There were statistically significant differences in the error number of TMT-A (0.00 (0.00, 1.00), 0.00 (0.00, 0.00), 0.00 (0.00, 0.00); χ2=10.11, P=0.006), the time of TMT-B ((81.17±36.83) s, (52.10±27.88) s, (47.72±23.18) s; F=5.16, P=0.011), the error number of TMT-B (3.00 (0.00, 4.00), 1.00 (0.00, 3.50), 0.00 (0.00, 0.00); χ2=7.16, P=0.028) and the number of backward (3.17±0.72, 3.50±1.08, 4.00±0.77; F=3.68, P=0.035) among the three subgroups of PD group. There were statistically significant differences between the PD group and the HC group in the time of TMT-A (PD: (64.03±15.96) s, HC: (53.00±19.50) s; t=2.77, P=0.007), the time (PD: (58.85±31.91) s, HC: (37.35±19.42) s; t=3.64, P=0.001) and error number (PD: 0 (0, 4), HC: 0 (0, 0); Z=-3.15, P=0.002) of TMT-B, the number of backward (PD: 3.63±0.90, HC: 4.98±1.21; t=-5.67, P=0.000) and VFT (PD: 14.48±3.37, HC: 16.15±2.03; t=-2.69, P=0.009). In the low and medium education level subgroups, the PD group showed worse results in three tests of executive function than the HC group, some with statistically significant differences (P<0.05). There was no statistically significant difference in the results of three tests of executive function between two subgroups of high education in the PD group and the HC group (P>0.05).@*Conclusions@#Executive functions of non-dementia PD patients are impaired. Education level may have a certain impact on cognitive function of PD patients.
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Objective To explore the feasibility of establishing an acute pericardial effusion animal model guided by ultrasound. Methods Six experimental pigs were anesthetized. A PTC needle was injected and guided to the right ventricular anterior wall under real-time high frequency ultrasound,40 ml and 80 ml normal saline were respectively infused into the pericardial cavity within 5 minutes. Ultrasonography and pathologic examination were applied to confirm this porcine model. The amount of the fluid was estimated by ultrasound at 1 hour and 8 hours after infusion. Results With ultrasound guidance,the PTC needle smoothly entered the pericardial cavity and the saline was successfully injected. The fluid dispersed from local to the entire pericardial cavity. Pericardial effusion last within 8 hours and no significant change of the fluid amount was found (all P ＞0.05). This acute pericardial effusion model was successfully established with a rate of 100%. Conclusions It is feasible to establish an animal model of acute pericardial effusion under the guidance of ultrasound. This method is safe,rapid and effective. It can provide a suitable animal model for the study of acute pericardial effusion.
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Objective@#To survey the prevalence and distribution of sleep disorders in patients with Parkinson disease (PD) and to analyze the influencing factors.@*Methods@#The prevalence and distribution of sleep disorders were surveyed with Parkinson Disease Sleep Scale (PDSS) among 206 PD patients. The association of sleep disorders with age, course of disease, cognitive function, motor function, depression, and the equivalent dose of levodopa (LED) was analyzed.@*Results@#The overall PDSS score in 206 patients was (116.9±21.4). The three most frequent items of sleep disorders were the overall sleep quality(181/206, 87.9%), difficulty in maintaining sleep(160/206, 77.7%)and nocturnal enuresis(151/206, 73.3%); the three least frequent items were early awaking(87/206, 42.2%), urinary incontinence(56/206, 27.2%)and hallucination(44/206, 21.4%). The three items with the lowest average scores were nocturnal enuresis(6.9±3.1), difficulty in maintaining of sleep(7.1±2.7)and overall sleep quality(7.1±2.0); three items with the highest average scores were audiovisual illusion(9.3±1.8), incontinence caused by motion disability(9.0±2.1) and early awaking with upper and lower limb pain(8.7±2.1). PD patients were divided into group 1 [Hoehn-Yahr(H&Y) stage 1.0-1.5], group 2 (H&Y stage 2.0-2.5) and group 3 (H&Y stage 3.0-4.0). One-way analysis of variance or non-parametric test showed that there were significant differences in the course of disease(F=21.91, P=0.00), total score and the subscale scores of Unified Parkinson Disease Rating Scale(UPDRS, UPDRS Ⅰ-Ⅳ) (F=90.67, χ2=12.86, F=31.20, F=60.17, χ2=24.01, all P<0.01), the Hamilton Rating Scale for Depression(HAMD) scores (χ2=11.06, P=0.00), LED (F=14.93, P=0.00) and Minimum Mental State Examination(MMSE) scores (χ2=9.81, P=0.01) among three groups. There was no significant difference in age and PDSS scores among three groups. The results showed that there were significant differences in terms of restless state and nocturnal dysphoria (F=5.12, P=0.01; F=3.27, P=0.04) between group 1 and group 3. The linear regression analysis showed that the HAMD and the LED scores had the greatest influence on PDSS score (R2=0.142, 0.196).@*Conclusion@#PD patients have a variety of sleep symptoms. The treatment of large doses of dopamine and depression contribute to the occurrence of PD sleep disorders.
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AIM: To evaluate the effect of GYY4137, a novel hydrogen sulfide (H2S) donor, on cytosolic lipid decomposition in mouse primary steatosis hepatocytes.METHODS: Oleic acid (OA) was used to induce hepatic steatosis model in vitro.The C57BL/6 mouse primary hepatocytes isolated and cultured by 2-step in situ perfusion were divided into 4 groups: the cells in control group were incubated with normal medium for 54 h;the cells in model group were incubated with OA at 1.2 mmol/L for 48 h followed by serum-free phenol red-free RPMI-1640 for 6 h;the cells in H2S group or DL-propar-gylglycine (PAG;an inhibitor of cystathione γ-lysase, inhibiting H2S synthesis) group were incubated with OA at 1.2 mmol/L for 48 h followed by serum-free phenol red-free RPMI-1640 which contained 1 mmol/L GYY4137 or 200 μmol/L PAG for 6 h.The glycerin release and the protein expression of hormone-sensitive lipase (HSL) in the cells were mea-sured.RESULTS: Compared with model group, the glycerin release and the protein expression of phosphorylated HSL (p-HSL) in H2S group decreased significantly, while those increased significantly in PAG group.CONCLUSION: In steatosis hepatocytes, exogenous H2S possibly decreases cytosolic lipid decomposition by decreasing the protein level of p-HSL.
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Infectious pancreatic necrosis (IPN) is a challenging complication of acute pancreatitis and can lead to poor prognosis.Over the years,open necrosectomy has become the main treatment modality for IPN,but it will cause high incidence rate of complications and mortality rate.In recent years,with the rapid development of minimally invasive surgery,many scholars have performed minimally invasive treatment for IPN patients and achieved good outcomes.This article introduces five minimally invasive treatment techniques,i.e.,percutaneous catheter drainage,minimally invasive retroperitoneal necrosectomy,endoscopic drainage + necrosectomy,laparoscopic necrosectomy,and advanced therapeutic strategy,pointed out that different minimally invasive techniques had different indications,and minimally invasive therapies should be selected based on IPN patients' general conditions to improve their outcome.
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Objective To sum up the nursing experience of injection of sulphur hexafluoride microbubbles as contrast agent for thyroid contrast-enhanced ultrasound (CEUS).Methods The clinical data of 413 cases who injected sulphur hexafluoride microbubbles as a contrast agent for CEUS were retrospectively analyzed.Nursing observation and coordination were done on the CEUS examination process,venous puncture technique,the correct configuration and use of sulphur hexafluoride microbubbles as contrast agents,operating process,the correct treatment of adverse reactions.Results The success rate of thyroid CEUS in 413 cases was 100％.After completion of the CEUS procedure,2 cases revealed slight dizziness,1 case with the contrast agent extravasation,others did not have adverse reactions such as dizziness,the contrast agent extravasation,skin rashes,itching,pain at the injection site.Conclusion The key nursing points including mastery of the whole CEUS process,operator's qualified venous puncture technique,the correct configuration and use of sulphur hexafluoride microbubbles for injection as contrast agent,careful nursing observation in the operating process and correctly treatment of adverse reactions are significant for enhancing success rate of thyroid CEUS and relieving relevant adverse effects.
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Objective To investigate the association between Has‐miRNA‐149 polymorphism and susceptibility of digestive tract cancer .Methods A systematic search of Pubmed ,EMBASE and Web of Science ,CNKI ,Wanfang was conducted for relevant studies .The odds ratios(OR) and 95% confidence intervals(95% CI) calculated by Stata12 .0 software were used to assess the asso‐ciation between Has‐miRNA‐149 polymorphism and risk of digestive tract cancer .The Q test ,I2 value and funnel plot were conduc‐ted to examine heterogeneity and publication bias ,respectively .Results A total of thirteen eligible studies containing 4 424 cases and 5 290 controls were included in this Meta analysis .There were significant relationships between Hsa‐miRNA‐149 polymorphism and susceptibility of digestive tract cancer (Domina model CT+CC vs .TT ,OR=0 .915 ,95% CI:0 .840-0 .996 ,P=0 .040 ;Hetero‐zygous model CT vs .TT ,OR=0 .880 ,95% CI:0 .803 -0 .965 ,P=0 .007) .In the stratified analysis ,it was found that the risk of colorectal cancer decreased in patients carrying CC/CT genotypes(OR=0 .834 ,95% CI:0 .715-0 .972 ,P=0 .021) ,especially in A‐sians (CT+CC vs .TT ,OR=0 .894 ,95% CI:0 .818-0 .977 ,P=0 .013) ,while that was not found in the Caucasoids .Conclusion Has‐miRNA‐149 polymorphism is associated with the susceptibility of digestive tract cancer .The CC/CT genotypes may decrease the risk of digestive tract cancer ,especially in Asians .
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Aim To investigate the effect of hydrogen sulfide on hepatic lipid accumulation in obese mice. Methods C57 BL/6 J mice were randomly divided into control group, model group, and NaHS group. The mice of the control group were fed with normal diet. The mice of the model group and the NaHS group were fed with high-fat diet. From the thirteenth week, the mice of NaHS group were injected intraperitoneally with NaHS (H2S donor) in a dose of 50 μmol·kg-1 per day for 4 weeks and the mice of the model group were injected with the same volume of saline. All mice were sacrificed at the end of the 16th week. The tis-sues of liver were homogenized and centrifugated. The supernatants were used for the determination of triglyc-eride and cholesterol in liver. The morphology of liver was tested by H&E staining. Liver lipid accumulation was determined by oil red staining. Total RNA was ex-tracted from frozen tissue of liver. PCR was used to de-tect CPT-1 , FAS gene expression and ELISA method was used to detect CPT-1,FAS activity in mice liver. Results The body weight of the mice from NaHS group and model group was bigger than that of the mice from control group. Compared with the model group, the body weight of the mice from NaHS group was less;the content of triglyceride and cholesterol in liver was lower; the degree of liver tissue pathological changes and lipid accumulation were alleviated; CPT-1 expres-sion and activity were increased; FAS expression and activity were decreased. Conclusions These data in-dicate that hydrogen sulfide can reduce the lipid con-tent of liver tissue in obese mice and alleviate fatty liv-er. The mechanism may be associated with the in-creased expression of CPT-1 and the decreased expres-sion of FAS in liver.