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Objective To investigate the detection rate of motoric cognitive risk syndrome (MCR)and explore the possible risk factors.Methods A total of 429 elderly patients from geriatric department of Zhejiang Hospital from October 2014 to September 2018 were recruited in the crosssectional study.General information and functional assessment including fall history,self-reported visual impairment and hearing impairment,depressive symptom,cognitive function and gait speed were collected.Patients with MCR were screened out according to the MCR diagnostic criteria.Multiple logistic regression analysis was used to analyze the associated risk factors.Results Seventeen patients(4.0％)met the MCR diagnostic criteria.The proportions of obesity,polypharmacy,cerebral vascular diseases,self-reported hearing impairment,depressive symptoms and slow gait were higher in MCR patients than in non-MCR patients(P＜0.05).Compared with non-MCR patients,MCR patients had lower mini mental state examination (MMSE) scores (P ＜ 0.01).After adjusting for associated confounding factors,multiple logistic regression analysis showed obesity (OR =3.74,95 ％ CI:1.14-12.23,P ＜ 0.05) and depressive symptoms (OR =5.79,95％ CI:1.76-19.06,P ＜ 0.01) were risk factors for MCR.Conclusions MCR is not uncommon in elderly patients.Obesity and depressive symptoms are closely associated with an increased risk of MCR.
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Objective To study effects of bitter almond on interstitial cells of Cajal (ICC) in old rats with slow-transit constipation (STC) and analyze mechanism of the gut purge of bitter almond.Methods Forty-five old SD rats were randomly divided into blank control group,model control group,bitter almond-treated group randomly (n=15,each).Compound phenanthroline was used to build the model of STC model.The bitter almond-treated group was given with bitter almond apozem,the other two groups were given with the same amount of saline.After 10 days,the carbon powder propulsion rates in the intestine were measured and specimens were taken.The ICC changes in terms of the number and distribution were observed by immunohistochemical method.The protein and mRNA expressions of c-kit in ICC were measured by Western blot and reverse transcription-polymerase chain reaction(RT-PCR).Results Compared with blank control group [(68.6 ± 6.0) ％,the carbon powder propulsion rates in the intestine in model control group[(47.7±± 1.7)％]were declined (P＜ 0.01).The areas of c-kit positive cell in colon were declined[(638.0 ± 23.5) μm2 vs.(723.7 ± 30.8)μm2]in model vs.blank control (P＜0.05).The mRNA expression of c-kit gene in ICC was declined [(0.3±0.1) vs.(1.0±0.1)] (P＜0.05),the expression of c-kit protein in ICC were declined[(0.2±0.2) vs.(0.5±0.2)] (P＜0.05).Compared with model control group[(47.7± 1.7)％],the carbon powder propulsion rates in the intestine in bitter almond group were increased[(63.4± 3.3)％ vs.] (P ＜0.01).The mRNA expression of c-kit gene in ICC were increased in bitter almond group (0.9 ±0.2) vs model control group[[(0.3±0.1)] (P＜ 0.01).The expression of c-kit protein in ICC were increased in bitter almond group[(0.5±0.3) vs.in model control 0.2±0.2)] (P＜0.01).Conclusions The bitter almond can promote the expression of c-kit mRNA and protein in colonic tissue of old STC rat interstitial and repair a fraction of ICC of STC rat interstitial,which promote intestinal peristalsis in slow-transit constipation rats.
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Objective To improve the understanding of pulmonary mucormycosis by analyzing the clinical manifestations,imaging features,diagnosis,treatment and prognosis of this disease.Methods The clinical data of eight patients diagnosed as pulmonary mucormycosis by histopathologic examination were retrospectively analyzed.Results Eight patients included six males and two females with age from 36 days to 66 years.Underlying conditions covered diabetes (n =4),renal transplantation (n =3),premature (n =1) and long-term corticosteroid treatment in two cases.Imaging manifestations revealed multiple irregular lumps or nodules in three cases,multiple cavities with thick wall in three cases,diffuse lung infiltrate in one case and lung opacities in one case.The diagnoses of seven patients were confirmed by percutaneous needle lung biopsy and the remaining one was diagnosed with fiberoptic bronchoscopy biopsy.Surgery combined with amphotericin B liposome(60 mg/d for three weeks)was applied to one patient who was cured with no recurrence after a 22 month follow-up.Three cases were given amphotericin B liposome (a newborn with 7mg/d for 62 days,the other two 60 mg/d for 31 days and 70 mg/d for 71 days respectively).All had achieved marked response with follow up from 8 to 29 months,but one patient relapsed and died of recurrent lung mucormycosis.The other three patients were treated with itraconazole 400-200 mg/d from 21 days to 1 year with duration of follow up from 1 month to 20 months.One patient was not evaluable due to missing.Two patients relapsed and one died.Conclusion Pulmonary mucormycosis is difficult to diagnose and treat with a high mortality.Percutaneous tranthoracic lung biopsy is a useful diagnostic method.Amphotericin B liposome or itraconazole may be active against mucus.Early control of causes is essential to improve the prognosis and reduce the recurrence in patients with pulmonary mucormycosis.
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Objective To investigate the clinical features,radiology,diagnosis and treatment of postkidney-transplant pulmonary mucormycosis.Method Three cases of post-kidney-transplant pulmonary mucormycosis were successfully diagnosed by histopathologic examinations.The clinical features of the cases were analyzed.The patients consisted of 2 males and 1 female,aged 39 to 54 yearn All patients were subjected to renal transplantation due to uremia,one was complicated with with diabetes,and pulmonary mucormycosis occurred 6 months,2 years and 6 years after kidney transplant respectively.Fever,cough,bloody sputum and chest pain were the main clinical manifestations.Multiple irregular massive or diffuse infiltrates in the lungs were the early CT findings.In a shoot time,multiple thick-walled cavities occurred in the pulmonary lesions.Pleural effusion was found in one patient.The lung specimens of patients were obtained by CT-guided percutaneous biopsy.Result The first patiem was cured after one year therapy by hraconazole,but recurred after 8 months.The second patient had a marked effect after a 21-day therapy by Itraconazole,but died of disseminated mucor for excessive immunosuppressant against the renal transplantation rejection.The third patient also had a marked effect,and was still in follow up.Condusion The post-kidney-transplant pulmonary mucormycosis is difficult in diagnosis and treatment.CT-guided percutaneous biopsy is one of effective ways for diagnosis.Itraconazole appears to be effective in treatment of pulmonary mucormycosis.Early diagnosis and an appropriate immune ftmction are the keys to improve prognosis and reduce recurrence