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Objective:To investigate the characteristics and evolution of mild motor symptoms (MMS) in patients with prodromal Parkinson′s disease (pPD).Methods:Based on the pPD cohort screened by Parkinson′s Disease Prodromal Clinical Assessment Scale in Nanjing community from July 2018 to December 2020, the clinical data of 30 patients with pPD who completed the baseline assessment and were followed up for at least 1 year were analyzed. According to the Unified Parkinson Diease Rating Scale Ⅲ (UPDRS-Ⅲ) score, the patients were divided into MMS group (UPDRS-Ⅲ score>3) and non-MMS group (NMMS group, UPDRS-Ⅲ score≤3). The differences and evolution characteristics of clinical characteristics between the 2 groups were compared. Multivariate linear regression was used to analyze the risk factors of motor symptom progression in pPD patients.Results:Among the 30 patients with pPD, 7 of 23 patients in the MMS group were converted to PD at the end of follow-up, 1 of 7 patients in the NMMS group were converted to PD at the end of follow-up. The UPDRS-Ⅲ score [10.00 (7.00, 17.00)], Montreal Cognitive Assessment Scale (MoCA) score [25.50 (24.75, 28.00)] and the Hamilton Anxiety Scale (HAMA) score [9.00 (5.00, 13.00)] at the end of follow-up of pPD patients were significantly higher than those at baseline [7.00 (4.00, 12.00), 24.00 (22.75, 25.25) and 8.00 (2.00, 11.00)], and the differences were statistically significant ( Z=-3.505, P<0.001; Z=-2.956, P=0.003; Z=-2.427, P=0.015).Subgroup analysis showed that UPDRS-Ⅲ score [11.00 (7.00, 18.00)], MoCA score [25.00 (24.00, 27.00)] and HAMA score [ 9.00 (6.00, 15.00)] at the end of follow-up in the MMS group were higher than those at baseline [8.00 (6.00, 12.00), 24.00 (22.00, 25.00) and 9.00 (3.00, 11.00)], and the difference was statistically significant (Z=-2.768, P=0.006; Z=-2.457, P=0.014; Z=-2.250, P=0.024). The Non-Motor Symptoms Questionnaire score at the end of follow-up in the MMS group (8.96±5.20) was significantly lower than that in the baseline (11.04±4.41), and the difference was statistically significant ( t=2.441, P=0.023).There was no significant difference in Mini-Mental State Examination (MMSE), Hamilton Depression Scale (HAMD), Rapid Eyes Movement Sleep Behavior Disorder Questionnaire-Hong Kong (RBDQ-HK) and Sniffin′ sticks olfactory test score at the end of follow-up in the MMS group. Only UPDRS-Ⅲ score in the NMMS group was increased at the end of follow-up [7.00 (5.00, 8.00)] compared with the baseline [4.00 (1.00, 4.00)], and the difference was statistically significant ( Z=-2.375, P=0.018). There was no significant difference in MoCA, MMSE, HAMA, HAMD, RBDQ-HK, and Sniffin′ sticks olfactory test score between the NMMS group and the baseline at the end of follow-up. Conclusion:The clinical conversion rate of pPD patients with MMS is high,and screening of this population should be paid attention.
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OBJECTIVE@#To investigate the effect of glucagon-like peptide 1 receptor agonists (GLP-1RAs) on body fat redistribution and muscle mass in overweight/obese patients with type 2 diabetes (T2DM).@*METHODS@#We retrospectively analyzed the data of 76 patients with body mass indexes (BMI)≥24 kg/m, who had an established diagnosis of T2DM in our department between December, 2014 and September, 2015. We divided these patients according to their BMI in overweight group (BMI of 24-27.9 kg/m, =14), obese group (BMI of 28-31.9 kg/m, =35) and severely obese group (BMI≥32 kg/m, =27). All the patients received treatment with GLP-1RAs (Exenatide or Liraglutide) for 3.0 to 29.0 weeks (mean 8.9 weeks), and their blood glucose, HbA1c and serum lipids were analyzed. For each patient, the fat and muscle masses were analyzed using a human body composition analyzer (JAWON-IOI353, Korea) before and after GLP-1RAs treatment.@*RESULTS@#Treatment with GLP-1RAs significantly decreased BMI and visceral adiposity index (VAI) in all the patients in the 3 groups ( < 0.05). The treatment significantly decreased the body weight in the overweight group and obese group by 2.70 kg (0.60-4.95 kg) and 2.65 kg (1.45-6.40 kg), respectively ( < 0.05), and significantly decreased the waist-to-hip ratio (WHR) in the overweight group ( < 0.05). The obese and severely obese patients showed significantly decreased percentage body fat (including both subcutaneous and visceral fat) and increased muscle mass after the treatment ( < 0.05). Compared with those in the overweight group, the percentage body fat and VAI were significantly decreased in the obese group after the treatment ( < 0.05), and the percentage of subcutaneous fat reduced and the muscle ratio increased more obviously in the obese and severely obese patients ( < 0.05).@*CONCLUSIONS@#GLP-1RAs treatment can significantly lower BMI and improve body fat distribution in obese patients with T2DM, especially in patients with a greater BMI.
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Humans , Adipose Tissue , Body Mass Index , Diabetes Mellitus, Type 2 , Glucagon-Like Peptide-1 Receptor , Hypoglycemic Agents , Obesity , Overweight , Retrospective StudiesABSTRACT
To explore the clinical risk factors of cerebral artery stenosis in young persons with cerebral infarction. Methods From January 2013 to December 2016, 90 youth persons with cerebral infarction in our hospital were divided into stenosis group and non-stenosis group. The possible risk factors of vascular stenosis were statistically analyzed. Results There were 59 cerebral artery stenosis patients in all 90 cases. The incidence was 65. 6％. Univariate analysis showed that there was significant difference in gender, smoking, drinking, hypertension, diabetes, uric acid and blood lipid in patients of stenosis group and non arterial stenosis group(P＜0. 05). Multivariate Logistic regression analysis showed that smoking, drinking, hypertension, diabetes, hyperuricemia and dyslipidemia were the main risk factors (P＜0. 05). Conclusion Cerebral artery stenosis is an important factor of cerebral infarction in youth persons. Smoking, drinking, hypertension, diabetes, hyperuricemia, dyslipidemia are the risk factors. We should have reasonable diet, give up smoking and alcohol, exercise moderately, adopt a healthy lifestyle, control blood pressure, blood sugar, blood lipid levels, thereby reducing the risk of cerebral infarction in youth persons.
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<p><b>OBJECTIVE</b>To assess the predictive value of Neuropad test on occurrence of diabetic foot ulceration (DFU) among type 2 diabetic patients.</p><p><b>METHODS</b>We divided 725 cases of type 2 diabetic patients into the high-risk and the non-high-risk groups of DFU based on the results of vibration perception thresholds(VPT) examination, which was widely used as a criteria for predicting DFU. Receiver operating characteristic (ROC) analysis was used to compare the effectiveness of Neuropad with 10 g Semmes-Weinstein monofilament (10 g SWMF) testing in predicting the risk of DFU.</p><p><b>RESULTS</b>Among 725 patients of type 2 diabetes, 6.1% were at a high risk of DFU. Compared to non-high-risk group, patients in high-risk group had older age, longer diabetes duration, higher values of complete colour change time (CCC time) of Neuropad and higher abnormal rate of 10 g SWMF (P<0.01). CCC time of Neuropad was shown to be better in predicting the risk of DFU than 10 g SWMF, and the area under the ROC curve was about 0.8, and the best cut-off value was 22.25 min.</p><p><b>CONCLUSION</b>Neuropad is an effective means for predicting of the risk of DFU, and can be used to prevent diabetic foot ulceration.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Diabetic Foot , Diagnosis , Neurologic Examination , Methods , Predictive Value of Tests , Risk AssessmentABSTRACT
Objective We aimed to describe the application value of continuous glucose monitoring system in patients with advanced gestational diabetes mellitus (GDM). Methods Pregant women in the medium and late pregant phases (24～35 weeks) underwent GDM screen test from January 2006 to April 2007. They first received 50 g glucose challenge test and 100g OGTT was performed 3 days later when the blood glucose was higher than or equal to 7.8mmol/L. According to the diagnostic criteria from American Diabetes Mellitus (ADA) 47 women were diagnosed to possess GDM and they were further divided into the test group (25 cases) and the control group (22 cases). The test group received 72 hours continuous glucose monitoring (CGMS). The control group adopted peripheral blood glucose monitoring using blood from the fingertip, 7 times per day. Results There were no records of consciousness hypoglycemic symptoms and hypoglycemia during monitoring. The CGMS data suggested that the record of the percent of high blood glucose was (17.5±3.1)%, percent of low blood glucose was (2.4±0.9)%, which were higher than those of the control group, which were (14.3±2.2)% and 0. Conclusions We recommend pregant women with GDM to undergo CGMS while using peripheral blood glucose monitoring with blood from the fingertip. It could systemicly evaluate the real control condition of blood glucose and ensure the safety of both mothers and babies.
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Objective:To explore the clinical results of the operation of posterior decompression,vertebral interbody fusion with cage and transpedicular screw fixation for the treatment of recurrent lumbar disc herniation.Methods:51 cases treated with the operation of posterior decompression,vertebral interbody fusion with cage and transpedicular screw fixation were reviewed retrospectively.The results were evaluated with Japanese Orthopedic Association score.Results:The average operative time was 160 minutes and the average blood volumn was 580 ml.51 cases were followed for an averge period of 3 years.There was a significant increase of JOA score in the latest follow-up(P
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0 05), and the adverse reaction for sulthiame was mild and no necessary to cure.Conclusion It is effective and safe in the treatment for GTCS with sulthiame.
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0.05).Conclusion The gene polymorphism of MMP-9/C1562T may be unrelated with IS.
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In medical work, we usually consider patients as our "God", but our "God" who actually don't know their rights of being patients. think doctors to be "the God", "The Saviour". Many of our medical staff are not realizing patiends' rights and that patients' alternatires of doctors is the core of retaining the relationship between patients and medical personnel. In the essay through establishing patients' rights, medical personnel will be restricted to their occupational morals.
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Objective To observe the neuroprotective effect of Gangliosides on rats with cerebral ischemia-reperfusion. Methods Rat models were established through middle cerebral artery occlusion and divided into sham-operation group, ischemia-reperfusion group and Gangliosides group. The volume of infarotion and changes of NAA and Lactate at different time point were evaluated by DWI and MRS examinations. Results The mean infarcted volume measured by DWI at 1 h, 3 h and 6 h after ischemia-reperfusion in Gangliosides group was (30.32?8.18) mm3, (35.17?12.45) mm3 and (31.4?8.56) mm3, respectively, versus (204.6?37.77) mm3, (218.9?67.33) mm3 and (213.4?99. 95) mm3 in ischemia-reperfusion group.There were significant differences between the two groups (allP
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Objective A method for the determination of 4-methylimidazole in soy sauce by capillary gas chromatography was studies.Methods The method consisted of a methylene chloride to elution,followed by concentration of the eluate.N,N-Dimethylaniline(IS) was added in and GC analysis of the eluate,prior to GC analysis.The GC analysis was carried out by DB-FFAP capillary column and nitrogen phosphorus detector(NPD).Results The linear range was 4.9mg~1.5?102 mg/L and the limit of detection was 0.16 ug/L.The average recoveries were 97.25%and 99.44% by stand addition method in 0.0102mg and 0.0602mg 4-methylimidazole.Conclusion The method was simple,rapid and sensitive.A useful method for determining 4-methylimidazole in soy sauce was provided for forensic analysis.