Transcranial sonography in differential diagnosis of Parkinson disease and other movement disorders / 中华医学杂志(英文版)

BACKGROUND@#Reports evaluating the efficacy of transcranial sonography (TCS) for the differential diagnosis of Parkinson disease (PD) and other movement disorders in China are scarce. Therefore, this study aimed to assess the application of TCS for the differential diagnosis of PD, multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and essential tremor (ET) in Chinese individuals.@*METHODS@#From 2017 to 2019, 500 inpatients treated at the Department of Dyskinesia, Beijing Tiantan Hospital, Capital Medical University underwent routine transcranial ultrasound examination. The cross-sections at the midbrain and thalamus levels were scanned, and the incidence rates of substantia nigra (SN) positivity and the incidence rates of lenticular hyperechoic area were recorded. The echo of the SN was manually measured.@*RESULTS@#Of the 500 patients, 125 were excluded due to poor signal in temporal window sound transmission. Among the 375 individuals with good temporal window sound transmission, 200 were diagnosed with PD, 90 with ET, 50 with MSA, and 35 with PSP. The incidence rates of SN positivity differed significantly among the four patient groups (χ2 = 121.061, P  0.017).@*CONCLUSION@#SN positivity could effectively differentiate PD from ET, PSP, and MSA in a Chinese population.

Antipsychotics And Electrocardiographic Monitoring In Patients With Schizophrenia

Objectives: Patients with schizophrenia are more likely to die prematurely than the general population. They have a higher risk of cardiovascular related morbidity and mortality. Antipsychotic medications are also known to be associated with the prolongation of the rate-corrected QT (QTc) interval, which is linked to dangerous arrhythmias. The primary objective of our study is to investigate the practice of electrocardiogram (ECG) monitoring for patients with schizophrenia who were hospitalised. The secondary objective is to evaluate the prevalence of QTc prolongation in this group of patients. Methods: We included patients with schizophrenia who were discharged from the acute general adult psychiatric wards of the Institute of Mental Health in Singapore from 1 July 2014 to 21 July 2014. A retrospective analysis of the medical records was carried out to assess if they had received ECG during their hospitalisation. We also analysed their risk of developing QTc prolongation. Results: We had a sample size of 107 patients. There were 31 patients (29·0%) who received ECG during their hospitalisation. Of the 95 patients who had moderate-to-high risk of developing QTc prolongation, 29 of them received ECG. Of the 31 patients who received ECG, 10 of them (32·3%) had QTc prolongation. Conclusion: The ECG monitoring in the study patients was inadequate, and as a result, we were unable to evaluate the prevalence of prolonged QTc interval with confidence. We recommend performing baseline ECGs for these patients and conducting ECG teachings for clinicians who work in the psychiatric service settings. ASEAN Journal of Psychiatry, Vol. 17 (2): July – December 2016: XX XX.

Opinions about diagnosis and treatment of multilevel cervical spondylotic myelopathy / 中国骨伤

There should be confusion about diagnosis and treatment for multiple segments cervical myelopathy in some respects. The author reviewed the literature and combined with clinical experience, proposed a new classification for cervical myelopathy according to responsibility segment areas, which dividing into single segment,double segments (continues or jumping type), multi-segment (≥ three segments). The responsible segments determination is the premise of diagnosis and also a key to determine surgical decompression segment. Decompression only according to imaging was not desirable, surgical segment should mainly relies on clinical, imaging, electrophysiological and comprehensive analysis to avoid surgery range expansion. Surgical approach and procedures are still the focus and hotspot of cervical myelopathy treatment, and no treatment standards and corresponding guidelines to consult. The author proposes that surgical approach should advocate the individual, and surgical procedure should follow simple instead of complicate, anterior and posterior combined decompression is not necessary in most cases, and anterior and posterior fixation are not need.

An experimental study on the combination of chondroitin sulfate with glycerin for the cryopreservation of corneal graft / 中华实验眼科杂志

BackgroundChondroitin sulfate(CS) is a highly viscous and elastic acid mucopolysaccharide extracted from animal soft tissues,with a wide range of biological activity for use in clinical ophthalmology.Interim preservation solution containing CS has a significant protective effect on corneal endothelial cells (CECs).However,the protective effect played by CS in long-term glycerol cryopreservation of CECs remains to be studied.Objective This study is mainly attempted to investigate the protective effect of CS on graft CECs after cryopreservation by glycerin,and to compare the preserving outcome with that of sodium hyaluronate (SH).MethodsOne hundred and four eyes of fifty-two female Wistar rats were divided into four groups randomly.The cornea grafts were evenly anointed on the surface of the endothelium by 3％ CS and 1％ SH,respectively,and then cryopreserved in glycerol in the 3％ CS group and 1％ SH group,and the corneas cryopreserved only in glycerin were assigned to the glycerin only group.The fresh corneas of matched rats were used as the normal control group.Ninety-six female SD rats were appointed as recipients to receive allogeneic penetrating keratoplasty (PKP) 2 months after the graft cryopreservation.The viability of CECs on the corneas cryopreserved for 20 days and grafts of 14 days following surgery was assessed using trypan blue & alizarin red stain.The ultrastructure of cryopreserved corneas was examined under a transmission electron microscope.The rejection index (RI) and graft survival time were evaluated by inflammatory scoring under the slit lamp 1 day after operation,and regular pathological examination was performed after 7,14 or 30 days.The expression of transforming growth factor-β1 ( TGF-β1 ) and intercellular adhesion molecule-1 ( ICAM-1 ) in corneas and grafts were detected by immunochemistry.ResultsCECs morphology was normal in fresh cornea in normal control group,presenting no blue stained cells after trypan blue staining.In the 3％ CS group,few blue-stained cells were seen:however,the number of blue-stained cells noticeably increased in the 1％ SH group and glycerin only group.The viability and density of CECs were significantly lower in the 1％ SH group and glycerin only group,compared with the 3％ CS group (P＜0.05).Edema of the endoplasmic reticulum,inflammatory infiltration and neovascularization were more severe in the 1％ SH group and glycerin only group than the 3％ CS group 14 days after PKP.Compared with the 1％ SH group and glycerin only group,the R1 of the 3％ CS group was significantly reduced and the CECs survival time was delayed after PKP ( P＜0.05 ).Immunochemistry revealed that the expression of TGF-β1 in grafts (A value)was up-regulated and that of ICAM-1 was down-regulated in the 3％ CS group,compared with the 1％ SH group and glycerin only group ( P＜0.05).ConclusionsThe combination of 3％ CS with glycerol to cryopreserve corneal donor can maintain the viability of CECs for a longer duration and improve the effectiveness of PKP.

Evaluation of surgical outcomes using imaging study for patients with slow transit constipation complicated with outlet obstruction / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the clinical significance of multiple radiography of the pelvis in the evaluation of surgical outcomes for patients with slow transit constipation complicated with outlet obstruction.</p><p><b>METHODS</b>Patients with slow transit constipation complicated with outlet obstruction were diagnosed by multiple radiography of the pelvis after screening using colon transit study. Surgery was performed according to the cause of the obstruction. Anorectal angle and the locations of perineum, pelvic peritoneum, and bladder were assessed by multiple radiography of the pelvis one month after surgery. The changes in locations of pelvic organs were assessed and the imaging appearance after the release of obstruction was observed.</p><p><b>RESULTS</b>A total of 48 patients were included. Rectocele repair, partial mucosectomy with rectopexy, and hysteropexy were performed. All the patients were followed up with a mean length of 19(6-58) months. Excluding 2 patients who had no symptomatic improvement, the mean bowel movements was 1.9 times per day in the remaining 46 patients(95.8%). Preoperative anorectal angle at the squeezing phase was(128.09±13.82) degree and the difference between squeezing and resting phase was (11.14±12.58) degree, while the postoperative angle was (180.26±9.98) degree and the difference(20.01±13.11) degree(P<0.05). Preoperative location of the perineum at the squeezing phase was(-2.05±0.83) cm and the difference was(2.23±0.78) cm, while postoperative location was (-0.50±1.13) cm and the difference was (2.18±1.04) cm(P<0.05). Preoperative location of the pelvic peritoneum at the squeezing phase was(4.91±1.32) cm and the difference was (1.32±0.89) cm, while postoperative location was (2.62±2.53) cm and the difference was (3.28±0.68) cm (P<0.05). Preoperative bladder location at the squeezing phase in patients with urological symptoms was (3.92±2.51) cm and the difference was(1.39±1.27) cm, while postoperative location was (2.15±1.55) cm and the difference was (1.98±1.54) cm(P<0.05).</p><p><b>CONCLUSION</b>Multiple imaging of the pelvis provides objective evidence in the evaluation of surgical outcomes for patients with chronic slow transit constipation complicated with outlet obstruction.</p>

Study of mental disorder due to brain damage / 法医学杂志

OBJECTIVE@#To study the incidence rate, pattern and affective factors of mental disorder due to brain damage.@*METHODS@#According to CCMD-2-R, 388 subjects with traumatic brain damage in the Psychiatric Hospital of Huainan city within last 5 years were assessed by three psychiatrists 6 months to 1 year after brain injury.@*RESULTS@#(1) 74.2% of the mental disordered due to brain injury have intellectual impairment, most of them is mild; (2) The intracranial hematoma, brain stem injury, brain injury extent, GCS, complicated mental disorder, and education have great effect on intellectual impairment; (3) There is an intimate relationship between the intellectual impairment and the brain stem injury, intracranial hematoma, GCS, brain injury extent, and unconsciousness time. There is an intimate relationship between the mental symptom and the brain injury extent, contusion and laceration of brain, frontal lobe injury, and intracranial hematoma. There is also an intimate relationship between the personality change and the frontal lobe injury, unfolding brain case treatment, and intracranial hematoma.@*CONCLUSION@#To assess overall mental disorder should rely on the characteristics of craniocerebral injuries.

Selective arterial embolization for the treatment of arterial hemobilia after biliary tract surgery:an analysis of therapeutic results / 介入放射学杂志

Objective To explore the feasibility and efficacy of selective arterial embolization for the treatment of hemobilia occurred after biliary tract surgery.Methods The clinical data of 16 patients with massive hemobilia after biliary tract operation,who were treated in our hospital during the period from March 1989 to August 2009,were retrospectively analyzed.Conservative treatment of hemobilia was initially adopted in all patients,and,if it failed,interventional management was carried out.Emergent artery angiography was performed in all patients,which was followed by selective arterial embolization of the bleeding arteries with Gelfoam particles and coils.Results Of the total 16 cases,15 received selective arterial embolization therapy and the remaining one died.No re-bleeding occurred during a follow-up period of 8 months to 3 years.Conclusion For the treatment of arterial hemobilia occurred after biliary tract surgery,selective arterial embolization with Gelfoam particles and coils is a safe,mini-invasive and effective therapy with few complications.

An analysis of the correlation between subclavian steal syndrome and central vertigo / 中国耳鼻咽喉头颈外科

OBJECTIVE To summarize the characteristics of central vertigo and subclavian steal syndrome(SSS)and analyze the relationship between them.METHODS A retrospective review of 87 cases of patients diagnosed with SSS based on the evidence of clinical symptoms and results of transcranial doppler(TCD),cervical doppler ultrasound(CDUS),head and cervical magnetic resonance angiography(MRA),or cerebral digital subtract angiography(DSA)was present for analyzing the clinical presentation between the central vertigo and the subclavian steal syndrome.RESULTS There were more male than female in the 87 cases;8.05% of patients were under the age of 50,37.93% from 50 to 65,and 54.02% over 65,showing the incidence of SSS increases with the age.In 64.37% of patients,vertigo was the only symptom;in 29.89% of patients,vertigo presented as an accompanying symptom;and in 5.75% of patients,there was no significant vertigo.Of all these patients,65.52% had left SSS,32.18% had right SSS,2.30% had bilateral SSS;there were more left side lesions than right side.CONCLUSION SSS is no longer a rare disease as investigation tools keep developing.Its incidence increases with age.As vertigo may be its only clinical presentation,SSS could be misdiagnosed very easyly.To avoid misdiagnosising,it is very important to screen for SSS in patients with vertigo for the diagnosis early.

The Effect of Intercostal Bronchial Artery Embolization in Treating Massive Hemoptysis / 实用放射学杂志

Objective To study the effect of intercostal bronchial artery embolization(BAE) with gelatinum sponge(GS) or polyvinyl alcohol(PVA) in treating acute massive hemoptysis.Methods Fifty-two patients with acute massive hemoptysis underwent selective bronchial arteries angiogaphy first,then superselective bronchial arteries embolization using 3F SP catheter with GS in group A(n=24) and with PVA in group B(n=28).Results In group A,immediate control of hemoptysis was achieved in 16 patients(66.67%),marked reduce in bleeding was seen in 7 patients(29.17%),the effective rate was 95.83%.In group B,immediate control of hemoptysis was achieved in 24 patients(85.71%),marked reduce in bleeding was seen in one patients(14.29%),the effective rate was 100%(P﹥0.05).All patients were followed-up for one year.The recurrent rate was 25%(6 cases) in group A and 3.57%(1 case) in group B(P﹤0.05).Conclusion BAE with PVA is effective and safe method in treating serious hemoptysis.