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Objective:To investigate clinical significance of the detection of bone mineral density(BMD)and serum levels of vitamin D in elderly patients with Parkinson's disease(PD).Methods:Sixty elderly patients with PD(the PD group)admitted in our hospital from June 2016 to December 2018 were enrolled in this retrospective study.And 60 healthy persons confirmed by annual health check-up matched for age and sex during the same period were included as the control group.PD patients were divided into the osteoporosis group(n=23)and the non-osteoporosis group(n=37). The clinical data, bone mineral density and serum vitamin D level were compared between the two groups.Multivariate Logistic regression method was used to analyze related factors for osteoporosis in PD patients.Results:The incidences of osteoporosis and vitamin D deficiency were higher in PD group than in control group[23 cases(38.3%) vs.13 cases(21.7%)、35 cases(58.3%) vs.21 cases(35.0%), all P<0.05]. Bone mineral density and serum 25-(OH)D level were lower in PD group than in control group[(0.77±0.08)g/m 2vs.(0.83±0.09)g/m 2, (25.65±8.65)nmol/L vs.(39.80±10.74)nmol/L, t=4.381 and 8.439, P<0.05]. The age, course of disease and H-Y grade were higher and serum level of 25-(OH)D was lower in the osteoporosis group than in the control group( P<0.05). Spearman correlation analysis showed that BMD and 25-(OH)D were negatively correlated with age, course of disease and H-Y stage, respectively, and BMD was positively correlated with 25-(OH)D( r=0.396, P<0.05). Multivariate Logistic regression analysis showed that vitamin D deficiency was an independent risk factor for osteoporosis in elderly PD patients( OR=2.332, 95% CI: 1.772-8.224, P<0.01). Conclusions:The incidence of osteoporosis is high in elderly PD patients, and vitamin D deficiency is often present.Vitamin D deficiency may be an independent risk factor for osteoporosis.
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OBJECTIVE:To observe the effects of dexmedetomidine (Dex) on postoperative agitation of Wilson's disease patients with secondary hypersplenism after genernl anesthesia of splenectomy.METHODS:A total of 60 Wilson's disease patients with secondary hypersplenism underwent general anesthesia of splenectomy duning Jan.-Dec.2016 were divided into control group and observation group according to random number table,with 30 cases in each group.Observation group was given intravenous pump of Dex 0.4 μg/kg at constant speed 15 min before anesthesia induction,and then maintained at 0.4 tg/(kg·h)till splenectomy completed.Control group was given constant volume of normal saline.Other anesthesia plans were same in 2 groups.Mean arterial pressure (MAP),heart rate (HR) and pulse oxygen saturation (SpO2) of 2 groups were observed before pumping (T0),before intubation (T1),1 min after intubation (T2),before extubation (T3),3 min after extubation (T4).Riker sedation-agitation score (SAS) were recorded in 2 groups at T3 and T4.The duration of stay in postanesthesia intensive care unit (PACU) and the occurrence of bradycardia were compared between 2 groups.RESULTS:At T0,there was no statistical significance in MAP,HR or SpO2 levels between 2 groups (P＞0.05).At T1,T2,T3 and T4,MAP and HR levels of 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance (P＜0.05).SpO2 were 100％ at each time point,there was no statistical significance between 2 groups (P＞0.05).Riker SAS scores of observation group was significantly lower than that of control group,with statistical significance (P＜0.05).The incidence of bradycardia in observation group was 26.67％,which was significantly higher than 3.33％ of control group,with statistical significance (P＜0.05).But this symptom was corrected after intravenous injection of atropine.The duration of stay in PACU in observation group was significantly shorter than control group,with statistical significance (P＜0.05).CONCLUSIONS:Dex can keep postoperative hemodynamics stable in Wilson's disease patients with secondary hypersplenism,reduce agitation and shorten the time of the patients transferring from PACU.
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BACKGROUND:Currently, neural stem celltransplantation can be performed through three main approaches:local lesions, blood circulation, and cerebrospinal fluid. OBJECTIVE:To review the transplantation of neural stem cells or neural precursor cells via the cerebrospinal fluid in the treatment of central nervous system diseases. METHODS:A computer-based search of PubMed and CHKD databases was performed to retrieve articles concerning transplantation of neural stem cells via the cerebrospinal fluid, and its application and therapeutic mechanism in the treatment of central nervous system diseases in both animal experiment and clinic study published from 2000 to 2009. RESULTS AND CONCLUSION:It is suitable for neural stem cellsurvival, proliferation, and differentiation in the cerebrospinal fluid. Transplantation of neural stem cells via the cerebrospinal fluid is effective and feasible to treat central nervous system diseases. However, some problems have not been solved, such as the source of neural stem cells, the optimal time window and celldose, the safety and the long-term effect. Further studies are needed to pave the way for the intrathecal injection of neural stem cells in the treatment of central nervous system diseases.
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Objective To study the feasibility and effect of endoscopic breast conserving surgery in the treatment of early stage of breast cancer(EBC) via transaxillary small concealing incision. Methods Twenty -one cases of EBC were treated by endoscopic breast conserving surgery,combined with the lipolysis and suction of the fat in axilla, via transaxillary small incision. Results There was no cancer residue in all the resected margins of all samples confirmed by the frozen sections. The lymph nodes metastasis was found in 3 cases. The average operation time was 81.6 minutes. Subcutaneous liquid collection occurred in one case postoperatively,the liquid disappeared quickly after treatment. All patient′s had a good breast configuration. All patients were followed-up for 3.1 months to 15.6 months after operation. There were no recurrence and distant metastasis in this series. Conclusions Breast conserving surgery can be smoothly performed by a small concealing incision with endoscope. This operation has many advantages, such as the incision is small and concealing, so it can improve the patients′ quality of life. The suction of the fat in axilla makes axillary dissection easier.