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Criteria for diagnosis of Alzheimer's disease (AD) is not available in China.The international criteria is not a proper choice due to issues such as translation and lead to low diagnostic rate and high rate of missed diagnosis.The research group of Alzheimer's Disease Chinese (ADC) reviewed knowledge and techniques in neuropsychology,neuroimaging,molecular biology,and clinical neurology,and systematically studied the detection techniques such as memory,language,visuospatial,executive function,and medial temporal lobe visual scores on MRI,and their optimal threshold and diagnostic value for the diagnosis of AD.Through a systematic review and consensus meeting,a diagnostic framework for screeningAD in the Chinese population was established.Among these methods,an operational standard for clinical pathology models increased the diagnostic sensitivity by 15％.The sensitivity and specificity of screening memory impairment increased by 18.1％ and 11.6％,respectively.The sensitivity of screening medialtemporal lobe atrophy increased by 24.5％ and missed diagnosis was decreased by 34.5％.An operational standard for clinical biology models,incorporating the latest molecular imaging and molecular biology techniques,has enabled the early diagnosis of AD in China.The framework combines a principled diagnostic guideline with an operational screening protocol,which is applicable to all clinical settings and of great significance for the early detection,early diagnosis and early treatment of AD.
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This was a case of 32-year-old HAN woman admitted to psychiatric hospital presenting for social withdraw,deluded ideas,unexplained runaways and suicide behaviors.She was diagnosed as schizophrenia and brought to the psychiatrist for unbearable behavior problems by her family.When admitted to hospital the patient showed significant depressive symptoms and delusions with influent speech,hypotonia,involuntary movements of distal limb and ataxia.Cognitive tests revealed multiple deficits.Consulted with the neurologist,a diagnosis of organic mental disorder was suggested.Magnetic resonance imaging showed slight widen of lateral ventricles and mild atrophy of caudate nucleus and cortex of frontal lobe.The family history was re-collected and found three family members shared the influent speech and ataxia.Then the clinical diagnose of Huntingdon Disease was made and validated with gene tests.
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Objective To evaluate the effect and mechanism of rt-PA combined with high pressure oxygen (HPO)on cerebral ischemia-reperfusion injury in rats.Methods The model of cerebral ischemia-reperfusion injury was constructed by using middle cerebral artery occlusion.The neurological function score;brain index,water content and infarction volume;SOD;LDH;NOS;MDA;LD;NO and NOS were measured.The protein and mRNA expressions of iNOS,BDNF,p75NTR and TrkB were also detected by RT-PCR and Western blot to evaluate and compare the protective effect of rt-PA combined HPO therapy. Results rt-PA combined HPO could significantly decrease the neurological function score;brain index,water content,and infarction volume;SOD;NOS;MDA;LD;NO and NOS but increase LDH content and the weight of rats,compared with rt-PA.In addition,rt-PA combined HPO could increase BNDF and TrKB expressions and downregulate the expressions of iNOS and p75NTR,compared with rt-PA (P<0.05).Conclusion The rt-PA combined HPO therapy has a greater protective effect than rt-PA therapy and its mechanism might be related to having antioxidant effects, increasing the expressions of BDNF and TrKB,and decreasing the expressions of iNOS and p75NTR.
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Objective To study the effect of blood coagulation function and nerve function of beraprost in the treatment of acute cerebral infarction.Methods 80 cases of acute cerebral infarction were randomly divided into 2 groups, 40 cases in the control group and 40 cases in the experiment group.The control group received routine treatment, the experiment group were treated with the same as the control group combined with beraprost.Changes of coagulation function and nerve function were compared pre-and post-treatment between two groups.Results Compared with pre-treatment, APTT, PT, Fib level, serum NGF level, Barthel score increased post-treatment of the two groups, D-D, serum NSE, S100b, NIHSS score decreased, compared with the control group, APTT, PT, Fib level, serum NGF level, Barthel score were higher in the experiment group, the total effective rate was higher than the control group, two D-D, serum NSE, S100β, NIHSS scores were lower than the control group, the differences were statistically significant (P<0.05).Conclusion Beraprost can reduce the high coagulation state in patients with acute cerebral infarction, improve the degree of neurological impairment, and has good clinical efficacy.
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Objective To compare the curative effect and safety of Shang ring circumcision and conventional circumcision .Methods Retrospectively analyzed the clinical data of 329 adult patients who were admitted into our hospital from January 2013 to May 2015, including 205 cases of Shang ring circumcision and 124 cases of conventional circumcision .The operation time , intraoperative and postoperative VAS pain scores , intraoperative bleeding , wound healing time , complications , and degree of penile appearances and overall satisfaction between the two groups were compared .Results Compared with conventional circumcision , Shang ring circumcision was associated with shorter oper-ative time, less intraoperative blood loss , lower intraoperative and postoperative VAS pain scores , lower adverse event rate , higher penile ap-pearances and overall satisfaction , and the difference was statistically significant (P<0.05).Conclusion Shang ring circumcision may be a safer and more effective choice in comparison with conventional circumcision for male patients , as it can shorten the time of operation and save the cost of health care .
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Objective To investigate the clinical efficacy and side reaction of tandospimne citrate capsules on treating patients with depression after stroke.Methods Seventy-eight patients who were diagnosed as anxiety and depression after stroke were taken as our subjects.They were randomly divided into control group (n =40) and treatment group (n =38).Patients in the control group were given conventional therapy for cerebral vascular disease and psychological treatment,while in the treatment group were given the same treatment besides tandospimne citrate capsules of 10 mg per times,3 times/d oral,and course of both two groups for 4 weeks.The patients of two groups were scored according to Hamilton Depression Scale(HAMD) at the time of pre-treatment and post-treatment.And the the clinical efficacy and side reaction were observed and compared.Results (1) HAMD scores of treatment group in 2,4 weeks after treatment had significantly lower than that before treatment ((8.09±2.21) vs.(6.31 ±2.28) vs.(11.98 ±2.17),P ＜0.05).HAMD scores of control group in the treatment at 2week was as same as that in 4 weeks((10.57 ±2.53) vs.(8.91 ±2.31)).There was statistically significant difference in two groups in 2,4 weeks after treatment in terms of HAMD scores(P ＞0.05).The total effective rate of control group was 31.6％ (12/38),and 92.5％ (37/40) in treatment group,and the difference was significant(x2 =63.69,P ＜ 0.01).In the course of treatment in the two groups,there were no obvious adverse reactions.Conclusion Tandospirone citrate capsules show the clinical curative effect in the treatment of anxiety and depression after stroke,and no obvious adverse reactions.
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Objective To investigate the relationship among carotid atherosclerosis,plasma homocysteine and D-dimer level in patients with acute cerebral infarction.Methods Two hundred and eightyseven cases of patients with acute cerebral infarction treated in Pudong Hospital,Shanghai from January 2011 to March 2012 were enrolled into the observation group and 287 cases of healthy people not suffering from cerebral infarction or other patients had nothing to do with cerebrovascular disease were selected into the control group.The serum levels of plasma homocysteine were determined by fluorescence polarization immunoassay (FPIA) and D-dimer level by double antibody clip method.At the same time,neck vascular artery ultrasound were performed by MycoCardR Reader Ⅱ.The relationship of carotid atherosclerosis with plasma homocysteine and D-dimer were compared between these two groups.Results There were significant differences on total cholesterol ((4.25 ± 0.92) mmol/L vs (4.98 ± 0.88) mmol/L,t =3.244,P ＜ 0.05),triacylglycerol ((1.48 ±0.82) mmol/L vs (1.78 ± 1.09) mmol/L,t =3.564,P ＜ 0.05),low density lipoprotein ((2.52-0.76) mmol/L vs (2.92 ± 0.73) mmol/L,t =2.987,P ＜ 0.05),high-density lipoprotein ((1.38 ± 0.26) mmol/L vs (1.06± 0.29) mmol/L,t =3.964,P ＜ 0.05),systolic pressure ((130.28 ± 14.78) mm Hg vs (152.98 ± 20.45) mm Hg,t =3.264,P ＜ 0.05),diastolic pressure ((78.45 ± 16.02) mm Hg vs (93.81 ± 16.88) mm Hg,t =2.785,P ＜0.05) and common carotid artery IMT(left:(0.86 ±0.41)mm vs (1.18 ±0.25)mm,t =2.164,P ＜0.05;right:(0.87 ± 0.39)mm vs (1.12 ± 0.29)mm,t =2.254,P ＜ 0.05) between observation group and control group.Homocysteine concentration and the D-dimer level of patients with carotid atherosclerosis were significant higher than that without carotid atherosclerosis (homocysteine concentration:(12.89 ± 6.56) μnol/L vs (3.17 ± 0.12) μnol/L,t =2.324,P ＜ 0.05 ; D-dimer level:(1.53 ± 0.59) mg/L vs (0.33 ± 0.23) mg/L,t =2.753,P ＜ 0.05).Conclusion The plasma homocysteine concentration and the D-dimer levels are correlated with carotid atherosclerosis in patients with acute cerebral infarction.
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Aim To establish an ideal two-dimensional polyacrylamide gel electrophoresis( 2-DE) method for serum proteomic research. Methods The 2-DE experiment of serum was opti-mized by adjusting the conditions of sample pretreatment and silver nitrate staining. Results An ideal 2-DE experiment method with higher repetition was established. The number of protein spots and the resolution were both increased,and this method was compatible with MS analysis. Conclusion After the adjustments and optimizations,an ideal method of 2-DE technique for serum is established,which has a high reference value for the relevant researches,and lays an experimental foundation for the search,analysis as well as identification of the disease related proteins in serum.
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Objective To improve the diagnosis and treatment of adenocarcinoma of bladder. Methods The data of 20 cases of adenocarcinoma of bladder from 1986 to 2004 were retrospectively analyzed. All patients underwent operation and the diagnosis was proven by histopathologic examination. Results Eighteen cases were primary adenocarcinoma of bladder,8 cases applied to radical cystectomy and 10 cases partial cystectomy. Two cases were urachal adenocarcinoma,and received extended partial cystectomy.Seventeen patients were followed up for 3 months to 5 years. The one-year survival rate was 52.9% (9/17),two-year survival rate 41.2% (7/17),and five-year survival rate 29.4% (5/17). Conclusion Radical total cystectomy is the best choice for primary adenocarcinoma of bladder and extended partial cystectomy for urachal adenocarcinoma. Radiotherapy and chemotherapy after operation can improve the treatment effect.
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Objective To assess the efficacy and safety of transurethral bipolar plasmakinetic resection of benign prostatic hyperplasia (BPH). Methods A total of 45 cases of BPH were treated by transurethral bipolar plasmakinetic resection of prostate (PKRP) and were followed up for 3-10 months.Results The weight of the resected prostate was 28-105 g with an average of (47?16) g, the operation time was 15-120 min with an average of (50?12) min. No case needed blood transfusion during the operation and no transurethral resection syndrome occurred. The mean catheterization time was 4 d and the mean postoperative hospital stay was 7 d. Peak urine flow increased from (7.3?1.5) ml/s to (16.2?4. 4) ml/s and IPSS decreased from (27.6?1.3) to (5.8?1.0) in 3 months postoperatively. Conclusion Transurethral bipolar plasmakinetic resection of prostate is effective and safe with less complications.
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AIM: To explore the therapeutic effects of flunarizine combined with aspirin in the treatment of migrainous cerebral infaction. METHODS: 38 cases of patients diagnosed as migrainous cerebral infaction were respectively given flunarizine 10 mg combined with aspirin 100 mg every night for a month. The observed indices included the dysfunction scores of nervous system, the total classes of living ability, and the accumulating rate of platelet and viscosity of plasma before and after the treatment. RESULTS: Before the treatment the dysfunction scores of nervous system and the living ability of the patients were 13.51 ? 4.78 and 3.45 ? 1.13 , and after the treatment the values were 4.34 ? 1.85 and 1.79 ? 0.72 respectively (P
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Objective： To study the changes of water molecular diffusion in the ischemic region by using MR dephase technique and discuss the potential mechanism of the diffusion changes at early stage. Methods: Totally 43 cases were studied retrospectively. There were 10 cases whose MRI examinations were performed within 6 hours，12 cases from 7－24 hours，7 cases from 2－7 days, 8 cases from 8－14 days, 6 cases from 15 days to 2 months. The apparent diffusion coefficients in the ischemic region were calculated. Results: The ADCav in the grey matter was 8.61×10－4mm2*s－1. The ADCav decreased to (4.72×10－4±1.51×10－4) mm2*s－1 in ischemic region at superacute stage, ADCav ratio to contralateral corresponding region was 0.55±0.18, and ADCav increased to (5.68×10－4±1.22×10－4) mm2*s－1 during the time range of 2-7 days, （9.22×10－4±2.07×10－4） during the time range of 8－14 days, and approaching （26.42×10－4+9.65×10－4） mm2*s－1 during the time range of 2 months. The pearson product- moment correlation between the changes of diffusion value and time was sighificent (r=0.95, P<0.001). ADCv increased at superacute stage and decreased over time. Conclusion: The diffusion of water molecules in ischemic region decreased at superacute stage, and the ADC increased over time. The anisotropy increased at superacute stage and decreased as the course developed. DWI could detect ischemic lesion much earlier than CT and routine MR examination. DWI has great value in the diagnosis of superacute stroke. The mechanism of the diffusion changes at early stage may be the intracellular toxicity edema.