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Objective:To analyze the electrophysiological characteristics and influencing factors of peripheral neuropathy in Parkinson's disease(PD)patients.Methods:Totally 68 PD patients and 30 controls were selected for neuroelectrophysiological evaluation, including items such as limb motor nerve terminal latency(LP)and amplitude and sensory nerve conduction velocity(SCV)and amplitude.Age, sex, serum folate, vitamin B 12, homocysteine and hemoglobin levels were also recorded for the two groups.The Hoehn-Yahr scale was used to assess patients and levodopa daily doses and levodopa equivalent daily doses were calculated.According to the criteria for neuroelectrophysiological abnormalities, 31 PD patients were found to have peripheral neuropathy and 37 PD patients did not have peripheral neuropathy. Results:In PD patients, a total of 952 peripheral nerves were examined, with 21.7% having motor nerve involvement(118/544)and 72.8%(297/of 408)having sensory nerve involvement.In the control group, a total of 420 peripheral nerves were examined, with 4.2%(10/240)having motor nerve involvement and 26.1%(47/180)having sensory nerve involvement.Compared with the control group, the wave amplitudes of motor nerve terminals were reduced in the PD group for the ulnar nerve( t=2.172/2.345, right/left), median nerve( t=2.104/2.543, right/left), and tibial nerve( t=2.340/2.444, right/left)(all P<0.05); compared with the control group, the wave amplitudes of sensory nerve terminals of the ulnar nerve( Z=3.535/3.439, right/ left), median nerve( Z=3.076/2.937, right/left), and peroneal nerve( Z=2.795/2.795, right/left)were all reduced in the PD group(all P<0.05); compared with the control group, sensory conduction velocities of the ulnar nerve( t=2.326/2.487, right/left), median nerve( t=3.269/2.386, right/left), and peroneal nerve( t=2.551/2.418, right/left)were prolonged(all P<0.05). The rate of abnormalities with the sensory nerve terminal wave amplitude( χ2=149.814, P<0.001)was higher than that of abnormalities with motor nerve terminal wave amplitude in PD patients; the rate of abnormalities with the sensory nerve terminal wave amplitude( χ2=58.364, P<0.001)was higher than that of abnormalities with sensory conduction velocities.Logistic regression analysis showed that increased folic acid( OR=0.825, 95% CI: 0.637-0.990)and vitamin B 12( OR=0.996, 95% CI: 0.991-1.000)were protective factors for PD peripheral neuropathy; H-Y score, levodopa daily dose( OR=1.009, 95% CI: 1.003-1.015), and increased homocysteine( OR=1.151, 95% CI: 1.041-1.273)were risk factors for PD peripheral neuropathy.After excluding confounding factors, H-Y classification( OR=3.213, 95% CI: 1.342-7.713)remained an independent risk factor for peripheral nerve injury in PD patients. Conclusions:In PD patients with peripheral neuropathy, both motor nerves and sensory nerves are involved, sensory nerves are more significantly involved, and axonal damage is more important than myelin loss; increased H-Y classification is an independent risk factor for peripheral nerve injury in PD patients.
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Objective:To investigate the clinical value of zoledronic acid in improving the prognosis of osteoporotic hip fracture and preventing its sequential contralateral hip fracture.Methods:A retrospective study of 206 patients diagnosed with hip fragile fractures in China Medical University Affiliated Shengjing Hospital and treated with anti-osteoporotic drugs after surgery was conducted. The prognosis of patients with hip fracture using survival rate analysis and the risk factors of acute febrile complications with multivariate analysis after zoledronic acid treatment were evaluated. Furthermore, chi-square test and multivariate analysis was used to explore whether zoledronic acid decreases the occurrence of the contralateral sequential fracture.Results:The 3-year survival rate of patients with overall hip fracture was higher in zoledronic acid treatment group compared with control group( P=0.026), with the incidence of fever at 53.3%. The age [ OR=0.786, P=0.027, the area under receiver operating characteristic (ROC) curve was 0.724] and cardiopulmonary complications ( OR=0.043, P=0.025, the area under ROC curve was 0.628) were significantly correlated with the occurrence of acute febrile response. The incidence of sequential contralateral fractures in zoledronic acid treatment group was significantly lower than that in control group ( χ2=4.356, P=0.037). The application of zoledronic acid ( OR=0.160, P=0.007, the area under ROC curve is 0.586) and the type of femoral neck fracture ( OR=0.196, P=0.001, the area under ROC curve is 0.607) were statistically associated with the occurrence of sequential fractures. Conclusion:Zoledronic acid treatment improves the outcome of patients with osteoporotic hip fracture and reduces the incidence of sequential hip fractures, especially femoral neck fracture. Senile age and cardiopulmonary complications might be associated with lower risk of acute febrile reactions after zoledronic acid treatment.
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Objective To discuss the efficacy and safety of sterile repositionable hemostasis clipping device in combination with high frequency electric snare in polypectomy of colorectal polyps with wide and long peduncle. Methods From January 2014 to December 2015, 21 cases of colorectal polyps with wide and long peduncle (diameter greater than 2 cm) in endoscopic treatment under electronic colonoscopy. We used 1 ~ 2 hemostatic clips to clip colorectal polyps roots, then used electric resection with high frequency electric snare electric coagulation. Postoperative bleeding, perforation were observed follow-up. Results 24 polyps in 21 cases were removed one-time successfully. Stump errhysis in 1 case, hot biopsy forceps is given to deal with local wound followed by Olympus Clip HX-610-135L EZ titanium clip. There was no complication such as bleeding and perforation in 3 to 6 months after the operation. In the colonoscopy examination, recurrence of polyps were not found in the original polyp resection site. Conclusion Sterile repositionable hemostasis clipping device in combination with high frequency electric snare in polypectomy of colorectal polyps with wide and long peduncle is safe and effective, without bleeding or perforation.
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Objective To explore the feasibility of high-frequency ultrasound detecting median nerve (MN) in type 2 diabetes mellitus(T2DM)with diabetic peripheral neuropathy(DPN).Methods Forty-two healthy volunteers were included as control group(Group A).Eighty-eight T2DM patients were divided into two groups according to symptoms,signs and electrophysiological results:with DPN (group C,46 patients) and without DPN (Group B,42 patients).The width(W),thickness(T) and cross-sectional area(CSA) of MN at 6 points [the wrist crease,pisiform bone,hamate bone,the 6 cm proximal to the wrist crease,the 4 cm proximal to tip of the medial epicondyle(ME) and the midpoint of the humerus] were evaluated.ROC curve was plotted to determine clinical diagnostic value of three lines on six points in diagnosis of DPN. Results ①Comparing with Group A,the width(P <0.05) except for the 4 cm proximal to tip of ME and the midpoint of the humerus,the thickness (P <0.05) except for the 4 cm distal to ME and CSAs of all points were enlarged in DPN patients(P <0.001).The width(P <0.05)at the wrist crease,hamate bone and the midpoint of the humerus,the thickness (P <0.01) at the wrist crease and pisiform bone,CSAs (P <0.01) of all sites except for the wrist crease were increased in Group B.Comparing Group B with C, the width at the wrist crease,the thickness in the midpoint of the humerus,CSAs except for the 4 cm proximal to ME and the midpoint of the humerus were dramaticlly increased in Group C(P <0.001).②A diagnostic value comparison:when diagnostic value of W,T and CSA at six points is the most predictive, the sensitivity is 80.4%,84.8%,84.8% respectively and specificities are all 54.8%.Diagnostic value of CSA and T is superior to the width.The CSA and T of the hamate bone level were the most predictive of DPN.The corresponding optimal cut-off value was 0.097 cm 2 ,0.233 cm respectively.Conclusions The backbone and the abnormal changes of different lines of the MN in DPN can be observed by high-frequency ultrasound.The width and thickness of the MN at six points are increased in different degree,but CSAs of all levels can enlarge.When diagnostic value of W,T and CSA at six points is the most predictive for DPN, the sensitivity is superior to specificity respectively.The CSA and T of the hamate bone levelare the most predictive for the evaluation of DPN.
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BACKGROUND:Osteonecrosis of the femoral head (ONFH) results from an interruption of the blood supply to the femoral head or injury-caused death of chondrocytes and bone marrow components. Many osteogenesis-related factors, such as Runt-related transcription factor 2 (Runx2), bone morphogenetic protein (BMP), osteoprotegerin and osteocalcin, are involved in the subsequent repair process. The Runx2 gene has been shown to control osteoblast differentiation and formation by upregulating the transcription of various mineralization-related protein genes, alowing osteoblast precursors differentiation into osteoblasts, and playing a key role in bone repair. METHODS/DESIGN:This retrospective, single-center, non-randomized, paralel-controled trial was performed at Shengjing Hospital of China Medical University, China. Fifteen patients with ONFH and 15 patients with osteoarthritis undergoing total hip replacement were included. Primary measure was Runx2messenger RNA (mRNA) expression in femoral head and neck tissue, and secondary measures included BMP-2, BMP-7 and osteoprotegerin mRNA expression, as wel as osteocalcin immunoreactivity. This trial was registered at ClinicalTrials.gov (identifier: NCT02735538) and acquired written approval from the Ethics Committee of Shengjing Hospital of China Medical University (approval No. 2016PS222K). Written informed consent was obtained from each included patient. DISCUSSION:This study involved in the detection of mRNA expression of several bone repair-related genes, including Runx2, in the femoral head and neck of patients with ONFH was performed between 2010 and 2011. This observational study wil help clarify the role and possible clinical significance of Runx2 in femoral head necrosis, bone repair and reconstruction.
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Objective To observe the effect of functional exercise guided by self muscle strength in early rehabilitation on patients after total knee arthroplasty (TKA). Methods From September, 2014 to September, 2015, 62 patients after TKA were randomly divided into ex-perimental group (n=31) and control group (n=31). The control group received conventional rehabilitation training, while the experimental group received rehabilitation training under the guidance of their own muscle strength standard. The degrees of swelling and pain seven days after TKA; the muscle strength seven and 15 days after TKA; the range of motion (ROM), the Keen Society Score (KSS) 15 days after TKA;and the postoperative hospital stay were compared. Results There was no significant difference in all the indexes above between two groups before TKA (t0.05), and all of them improved after TKA (t>3.470, P2.280, P0.850, P>0.05), and the functional score was higher in the experiment group than in the control group (t=5.870, P<0.001) 15 days after TKA. The postoperative hospital stay was shorter in the experiment group (t=7.65, P<0.01). Conclusion Functional exercise under the guidance of their own muscle strength standard could contribute to the improvement of postoperative muscle strength and knee joint function, and shorten the hospitalization stay.
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<p><b>OBJECTIVE</b>To investigate the risk factor of cholecystitis after radical gastrectomy for gastric cancer.</p><p><b>METHODS</b>Clinicpathological data of 553 gastric cancer patients with normal gallbladders undergoing radical gastrectomy in Tianjin Medical University Cancer Institute and Hospital between March 2013 and March 2015 were analyzed retrospectively. Univariate and multivariate analysis were applied to evaluate factors influencing the cholecystitis after radical gastrectomy using log-rank and logistic regression model.</p><p><b>RESULTS</b>There were 360 males and 193 females with a median age of 60 years. All patients were followed up from 6 months to 2 years. The incidence of cholecystitis after radical gastrectomy for gastric cancer was 33.1%(183/553), while incidence of cholecystolithiasis was 4.9%(27/553). In addition, the cholecystitis incidence of patients with No.12 lymph node cleaning was 39.6%(89/225), while with No.8a lymph node cleaning was 38.0%(151/397), with No.5 lymph node cleaning was 38.0%(68/179), with No.7 lymph node cleaning was 34.4%(138/402), with No.9 lymph node cleaning was 34.7%(136/392). Univariate log-rank test indicated that the lymphadenectomy of No.8a(χ(2)=15.530, P=0.000), No.12 group(χ(2)=7.157, P=0.007) and surgical methods (χ(2)=7.427, P=0.024) were significantly associated with cholecystitis after radical gastrectomy. Multivariate analysis showed that the lymphadenectomy of No.8a was independent factor of cholecystitis after radical gastrectomy (OR=2.016, 95% CI:1.244 to 3.267, P=0.004).</p><p><b>CONCLUSIONS</b>Vagal nerve trunk and sympathetic ganglion should be protected carefully during No.8a lymphadenectomy in radical gastrectomy for gastric cancer, in order to reduce the incidence of postoperative cholecystitis.</p>
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Female , Humans , Male , Middle Aged , Cholecystitis , Epidemiology , Gastrectomy , Logistic Models , Lymph Node Excision , Lymph Nodes , Multivariate Analysis , Postoperative Period , Retrospective Studies , Risk Factors , Stomach Neoplasms , General SurgeryABSTRACT
Objective To observe the response of left ventricular (LV)function and structure to chronic intermittent hypoxia (CIH)early stage in New Zealand white rabbits by echocardiography.Methods The New Zealand white rabbits were placed in the CIH chamber and exposed to hypoxia for 8 weeks (6 hours/day,6 days/week).The flow of nitrogen and oxygen were regulated into the customized chambers by the gas control delivery system.The fraction of inspired oxygen was changed from 21 % to 8% for 25 s of every 1 70 s.LV structure and function was assessed by echocardiography at CIH 0,1 ,2,4,6,8 weeks and histopathology was done by HE staining simultaneously.Results ①LV structural variables:compared with 0 week,LV posterior wall and interventricular septum thickness thickened at 6 week.LV end diastolic increased at 8 week (P 1 .Isovolumic relaxation time (IVRT)decreased at 1 week and 2 week,but increased at 8 week (P < 0.05 ).④ The myocardial pathology showed that myocardial fibers disordered slightly,cardiomyocytes swelled,nuclei increased and intracellular edema when exposed to CIH for 2 week and 4 week.Vacuolar degeneration,edema and congestion were found in intercellular substance at 6 week and 8 week.Conclusions ① LV systolic and diastolic function compensation started at CIH early stage then LV structure abnormality advent later.②IVCT and IVRT are sensitive indicators of LV systolic and diastolic function compensation.
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Objective To evaluate the right ventricular (RV) systolic function in patients with systemic lupus erythematosus (SLE) by speckle tracking imaging (STI).Methods A total of 40 cases with SLE were divided into two groups,SLE (24 cases) and SLE complicated with pulmonary arterial hypertension (PAH) (16 cases).Meanwhile,35 healthy subjects were used as control group.Longitudinal peak systolic strain (PSS) of the basal,mid,apical segments of the free wall of right ventricular and interventricular septum and suben-docardial myocardium of the whole right ventricular were measured by STI respectively.Every parameter was compared.And the main factors affecting the strain of the whole right ventricule were analyzed.T test,one-way ANVOA,SNK-q,Spearman's correlation and Pearson's correlation analysis were used for statistical analysis.Results ① In SLE group,strains of the whole RV(GLS RV) [(-22±4)％] and all segments of RV wall[the basal segments of free wall (bas FW) (-27±8)％ were lower than that of the control group (-26±4)％,(-33±6)％,respectively (t=-4.815,P=0.000; t=-3.619,P=0.001)].Tricuspid valve orifice peak velocity E/A and right ventricular ejection fraction were significantly different between SLE group and control group (P＜0.05).② In terms of conventional parameters and the strain of all segments of RV wall,bas FW and GLS RV were different between the SLE group [(-30±7)％,(-23.7±3.5)％,respectively] and SLE with PAH group [(-22±6)％,(-18.4±2.3)％,respectively] (t=-3.581,P=0.001; t=-5.769,P=0.000).③ The RV anterior wall thickness of the moderate-severe subgroup was significantly higher than that of the mild group [(5.0±0.8) mm,(4.3±0.8) mm; t=-2.49,P=0.017].GLS RV[(-19±4)％,(-24±7)％;t=-3.016,P=0.015],bas FW [(-22±9)％,(-35±6)％; t=-3.125,P=0.03] and bas IVS [(-19±6)％,(-24±6)％; t=-2.272,P=0.029] were significantly lower than that of the mild group.Conclusion Right ventricular function is decreased in patients with SLE.STI can be used objectively to assess the right ventricular longitudinal systolic function.
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Objective To investigate the relationship between body mass index (BMI) and blood pressure in non-stroke population with over 50 years old from Dongcheng District and Shijingshan District of Beijing.Methods A total of 9 524 of non-stroke population with over 50 years old were selected as our subject,which were sampled from Dongcheng District and Shijingshan District of Beijing by using stratified cluster random sampling method.Investigation and physical inventory check were conducted on all subbjects conduct,and the results was statistical analyzed by using SPSS 17.0 software.Results Systolic blood pressure and diastolic blood pressure of all subjects increased with the increasing of BML The prevalence of hypertension of three age groups were significant different between male and female (Z =-50.47,P ＜ 0.001).The prevalence of hypertension in males with 50-59 years old was considerably higher than that of females (x2 =14.74,P ＜0.001).However,the prevalence of hypertension in females with 60-69 years old and ≥70 years old group were higher than that of males (x2 =12.39,P ＜ 0.001 ; x2 =10.36,P =0.001).Overall,the prevalence of hypertension between males and females was no significant (male for 37.9％,female 37.3％,x2 =0.31,P =0.578).BMI increased with the increasing blood pressure levels and prevalence of hypertension,taking the people with BMI ＜ 18.5 kg/m2 as reference,OR values of the risk for male people with BMI 18.5-24.0kg/m2,24.0-28.0 kg/m2,and ≥ 28.0 kg/m2 to get hypertension people were 1.622 (95％ CI:0.653 -4.029),2.405 (95％ CI:0.940-5.940),4.248 (95％ CI:1.709-10.559) respectively,while for female people were 2.212 (95％ CI:1.193-4.104),3.870 (95％ CI:2.092-7.157),6.603 (95％ CI:3.557 -12.258) respectively.Conclusion Overweight and obesity are risk factors of hypertension.Obesity control contributes to the prevention and treatment of hypertension in middle-aged and elderly population.
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Objective This research is to observe the treatment effects of hip bath and oxygen blowing on severe neonatal diaper rash.Methods 289 neonates with severe diaper rash were randomly divided into three groups.91 cases in the flat tube group,102 cases in the round tube group and 96 cases in the control group.Three groups of neonates were cleaned on the hips and perineuma after poops and then dried with wet tissues and Mupirocin Ointment.The control group was treated with the above-mentioned method.The oxygen blowing groups were treated with hip bath of 1:5000 chameleon solution twice a day.Blowing the hips with oxygen five minutes every time after hip bath.The method of blowing oxygen was that oxygen humidifying containers as normal oxygen aspiration facilities was not filled with water,whose oxygen flowing volume standed at 10 L/min and whose tube blew at the afflicted parts until being dry.The oxygen blower held the oxygen exit and blowed at the afflicted parts in the round tube group and the oxygen blower flattened the oxygen exit and blew at the afflicted parts in the fiat tube group.The treatment effects will be compared among the three groups four days later.Results The cure period of the round tube group was obviously shorter than that of the control group,and the cure period of the fiat tube group was remarkably shorter than that of the round tube group.The total effective rate in the round tube group was obviously higher than that of the control group and the total effective rate in the fiat tube group was obviously higher than that in the round tube group.The difference had a statistical significance.Conclusions The treatment effects for the severe neonatal diaper rash with hip bath and oxygen blowing are remarkable and the oxygen blowing effects with fiat tubes are better than those with round tubes.
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BACKGROUND: At present, there has been no definite experiment systemically evaluating adherent separation and density gradient centrifugation to isolate bone marrow mesenchymal stem cells (BMSCs). Whether the two methods produce different influences on BMSC induction and differentiation remains unclear.OBJECTIVE: This study was designed to verify difference of these two isolation methods in chondrogenic differentiation of BMSCs.DESIGN, TIME AND SETTING: A controlled observation was performed at the Shengjing Hospital Affiliated to China Medical University from March to September 2005. MATERIALS: Twenty Japanese big-ear rabbits, aged 2-3 months, weighing 1.2-2.0 kg, were included for this study. METHODS: BMSCs were isolated by adherent separation and density gradient centrifugation. Two groups of BMSCs were taken from the same passage and induced towards chondrogenic differentiation with transforming growth factor beta 1. MAIN OUTCOME MEASURES: Growth of BMSCs was observed under an inverted microscope to draw growth curves; Type II collagen expression was detected by immunohistochemistry. Type II collagen mRNA expression was determined by in situ hybridization. RESULTS: The growth curves demonstrated that cellular growth velocity of the two groups tended to be the same. Immunohistochemistry results showed that the efficiency of adherent separation and density gradient centrifugation for promoting chondrogenic differentiation of BMSCs was 76.1% and 77.7%, respectively, and in situ hybridization results showed that the efficiency was 70.3% and 71.0%, respectively. No significant difference in differentiation efficiency existed between the adherent separation and the density gradient centrifugation. CONCLUSION: Adherent separation and density gradient centrifugation had no different influences on BMSC growth and chondrogenic differentiation.