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Neurofibrillary tangle-predominant dementia(NFTPD)is one type of late-onset dementia, with memory disorders as the main clinical manifestation.The pathological feature is the presence of a large number of neurofibrillary tangle(NFT)in the hippocampus with no or little amyloid deposition in the brain.In recent years, primary age-related tauopathy(PART)has been proposed as a new pathological term, which means that NFT appears in the medial temporal lobe with aging, but no amyloid deposits, and NFTPD is one type of dementia associated with the progression of PART.
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Objective@#To investigate the prevalence of autonomic dysfunction and its influencing factors in the elderly in Jizhou community of Tianjin.@*Methods@#By using a cross-sectional study, a questionnaire survey was conducted in the elderly in order to investigate the prevalence of autonomic dysfunction and its influencing factors.@*Results@#A total of 1 292 elderly patients were enrolled.Of them, 196 cases had autonomic dysfunction(15.2%, 196/1 292). The main symptoms of autonomic dysfunction were frequent urination, urination urgency, urination incontinence(19.7%, 255/1 292)and constipation(15.9%, 205/1 292). Multivariate Logistic regression analysis showed that women(OR=1.808, 95%CI: 1.253~2.607), 75-85 years of age(OR=1.573, 95%CI: 1.109~2.232), general anesthesia history(OR=1.552, 95%CI: 1.044~2.307), sleep disorders(OR=2.906, 95%CI: 1.506~2.916), diabetes(OR=1.791, 95%CI: 1.197~2.678)and headache(OR=2.589, 95%CI: 1.482~4.520)were risk factors for autonomic dysfunction.@*Conclusions@#The prevalence of autonomic dysfunction is high in the elderly in Jizhou community of Tianjin city.It is necessary to pay great attention to potential risk factors of autonomic dysfunction in the elderly.And the autonomic dysfunction symptoms should be diagnosed and treated as early as possible.
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Objective To investigate the prevalence of autonomic dysfunction and its influencing factors in the elderly in Jizhou community of Tianjin.Methods By using a cross-sectional study,a questionnaire survey was conducted in the elderly in order to investigate the prevalence of autonomic dysfunction and its influencing factors.Results A total of 1 292 elderly patients were enrolled.Of them,196 eases had autonomic dysfunction(15.2％,196/1 292).The main symptoms of autonomic dysfunction were frequent urination,urination urgency,urination incontinence (19.7 ％,255/1 292) and constipation(15.9 ％,205/1 292).Multivariate Logistic regression analysis showed that women(OR =1.808,95 ％CI:1.253 ～ 2.607),75-85 years of age (OR =1.573,95 ％ CI:1.109 ～ 2.232),general anesthesia history(OR =1.552,95％CI:1.044～2.307),sleep disorders(OR =2.906,95％CI:1.506 ～2.916),diabetes(OR =1.791,95％CI:1.197～2.678) and headache(OR =2.589,95％CI:1.482～4.520)were risk factors for autonomic dysfunction.Conclusions The prevalence of autonomic dysfunction is high in the elderly in Jizhou community of Tianjin city.It is necessary to pay great attention to potential risk factors of autonomic dysfunction in the elderly.And the autonomic dysfunction symptoms should be diagnosed and treated as early as possible.
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Neurofibrillary tangle-predominant dementia (NFTPD)is one type of late-onset dementia,with memory disorders as the main clinical manifestation.The pathological feature is the presence of a large number of neurofibrillary tangle(NFT)in the hippocampus with no or little amyloid deposition in the brain.In recent years,primary age-related tauopathy(PART)has been proposed as a new pathological term,which means that NFT appears in the medial temporal lobe with aging,but no amyloid deposits,and NFTPD is one type of dementia associated with the progression of PART.
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Objective To investigate the clinical,neuroimaging and pathological features of patients with corticobasal syndrome (CBS).Methods Three CBS patients underwent neuropsychological assessment,MRI scan,18F-FDG PET scan,and 11C-PiB PET scan,and the test results were analyzed.Results All three patients showed poor response to levodopa treatment and asymmetric dyskinesia including rigidity,tremor,dystonia and abnormalities in posture and gait.One patient showed apraxia and three patients presented with cognitive impairment.The crania MRI demonstrated mild cerebral atrophy which was slightly more severe in the contralateral side of the initially affected limb.The (18)F-FDG PET/CT scan revealed asymmetric decreased metabolism in the frontal,parietal,temporal,and insular lobe,as well as in basal ganglia.The results of (11)C-PiB PET showed that amyloid beta-peptide (A Beta) deposition in the cortex was positive in one patient,and negative in the other two patients.Conclusions Corticobasal syndrome is characterized by asymmetric dyskinesia and cognitive impairment,and often associated with apraxia,cortical sensory deficits,and alien limb phenomena.The MRI and FDG PET are helpful for CBS diagnosis,and the PiB PET facilitates the pathological diagnosis.
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Objective To compare cognitive ,behavioral ,and psychological symptoms observed in Alzheimer's disease (AD ) and dementia with Lewy body (DLB ) in order to provide helpful information for differential diagnosis. Methods We selected 215 patients with AD (AD group)and 66 patients with DLB(DLB group)to retrospectively analyzed their general information ,family history , and disease history.The Mini-Mental State Examination(MMSE scale)was used to evaluate cognitive abilities and Neuropsychiatric Inventory ( NPI scale ) was used for analysis of behavioral and psychological symptoms of dementia in both groups. Results The prevalence of hypertension was higher in the AD group(52.6%,n＝113)than in the DLB group(40%,n＝24)(P＜0.05).The DLB group showed better general cognitive scores ,disorientation scores ,immediate recall scores ,and delayed recall scores than the AD group. Fluctuating cognitive deficiencies and Parkinson's symptoms were more prevalent in the DLB group than in the AD group with 2 patients (0.9%) showing fluctuating cognitive deficiencies in the AD group ,and 19(28.8%)in the DLB group(χ2＝8.580 ,P＝0.003) ;with 26 patients(12.1%)showing Parkinson's symptoms in the AD group and 25(37.9%)in the DLB group(χ2＝ 22.602 ,P＝ 0.000).As to behavioral and psychological symptoms ,the DLB group had higher scores in total NPI ,hallucinations and nighttime abnormal behaviors with 32 patients (14.9%)showing hallucinations and 64 (29.8%)showing nighttime abnormal behaviors in the AD group ;30(46.2%)showing hallucinations and 30 (46.2%)showing nighttime abnormal behaviors in the DLB group (all P ＜ 0.05 ) . Conclusions Hypertension is more prevalent in AD patients. Fluctuating cognitive deficiencies ,Parkinson's symptoms ,hallucinations ,and nighttime abnormal behaviors are prominent manifestations in DLB patients.
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Objective To investigate the characteristics of cognitive function and mental behavior symp-toms in patients with Parkinson′s disease dementia(PDD)and dementia with lewy body(DLB).Methods Forty-eight patients with DLB and 38 with PDD were collected in Tianjin Huanhu Hospital and Tianjin Jianhua Hospital. All patients were assessed on cognitive function and mental behavior symptoms using Montreal Cognitive Assess-ment Scale,Mini-Mental State Examination,Hamilton Depression Scale,Hamilton Anxiety Scale and The Neuro-psychiatric Inventory Questionnaire.The Unified Parkinson Disease Rating Scale-Part 3(UPDRSⅢ)and modified Hoehn Yahr staging were used to assess the severity of motor symptoms in patients. Results Scores of UPDRSⅢ,posture and gait disorder were higher in DLB group than those in PDD group but the score of tremor was lower in DLB group than that in PDD group. The proportions of non tremor onset and bilateral onset were also lower in DLB group than those in PDD group,and the differences were statistically significant(P<0.05).Cognitive func-tion impairment was more serious in DLB group than that in PDD group in all cognitive fields including execution, attention,visual space,orientation and the difference was statistically significant(P < 0.05). Hallucinations (81.3%)and irritability/emotional instability(62.5%)were more common in DLB group but apathy(76.9%),de-pression(73.7%)and anxiety(73.7%)were more common in PDD group. Conclusions Cognitive impairment is more progressive in DLB patients than that in PDD patients.Hallucinations and irritability/emotional instability are more common in DLB group but apathy,depression and anxiety are more common in PDD group.
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Objective To compare the neuropsychological features and other clinical and imaging characteristics among patients with typical Alzheimer's disease (TAD),frontal variant Alzheimer's disease (fvAD) and behavioral variant frontotemporal dementia (bvFTD).Methods Neuropsychological scales were used to evaluate the cognitive function and neuropsychiatric symptoms of nine patients with fvAD,30 patients with bvFTD and 32 patients with typical AD (TAD).The apolipoprotein E (ApoE) ε4 allele and brain imaging techniques,including the magnetic resonance imaging (MRI),11 C-Pittsburgh compound B positron emission tomography (PIB-PET),and 18F-deoxyglucose positron emission tomography (FDG-PET),were used for the differential diagnosis of fvAD and bvFTD.Results There were no significant differences in general cognitive function or daily activity in patients among the three groups.However,the cognitive subscale scores of Montreal Cognitive Assessment (MoCA) scale,including visual acuity and executive function,delayed recall,and orientation,were significantly different among the groups (Z =7.891,P =0.035;Z =7.412,P =0.031;Z=6.437,P=0.043,respectively).The clock drawing test (CDT) score of TAD group was higher than that in the bvFTD and fvAD groups (Z=8.673,P=0.020),while the neuropsychological questionnaire (NPI) scores of the bvFTD and fvAD groups were higher than those of the TAD group (Z=7.577,P =0.023).Meanwhile,the incidences of agitation,disinhibition and abnormal behavior of NPI in the bvFTD and fvAD groups were higher than those in the TAD group (x2 =11.139,P =0.004;x2 =6.481,P =0.039;x2 =6.812,P =0.033,respectively).The frequencies of the ApoE ε4 allele were 44.4％ in the fvAD group and 33.3％ in the bvFTD group,which were not significant different from that in the TAD group (40.6％).Furthermore,patients in the fvAD group were associated with decreased regional cerebral glucose metabolism and amyloid deposition in the temporalparietal cortex evaluated by FDG-PET and PIP-PET.Conclusions Neuropsychological evaluation is valuable for the differential diagnosis of TAD,fvAD and bvFTD.The frequencies of the ApoEε4 allele are similar among the three groups.FDG-PET and PIB-PET imaging plays an important role in the diagnosis of variant types of Alzheimer's disease.
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Objective To provide evidence for diagnosis and treatment by investigating the pathogens and drug resistance of immunocompromised host (ICH)pneumonias.Methods Statistical method was used to analyze retrospectively the data of pathogens and drug resistance of ICH pneumonia treated in our hospital in 2014. Results We confirmed 187 cases of ICH pneumonia by pathogen study of 324 patients.Gram-negative bacillus (68.42%)was the main pathogen of ICH pneumonia.Acinetobacter baumanii (AB)accounted for the first place. Staphylococcus aureus infection was still the first of Gram-positive coccus.Conclusion Gram-negative bacillus was the main pathogen of ICH pneumonia in our hospital and the isolated bacteria show strong antibiotic resistance. Therefore,it is necessary to strengthen dynamic monitoring of pathogens in the secretions from ICH pneumonia patients’ lower respiratory tract and drug resistance.It is suggested that clinicians make anti-infection treatment cover drug-resistant bacteria.
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Objective To explore the association between rs7049105, rs647188, rs1333035 of chromosome 9p21 and the LAS among Chinese Han population of Changsha;to explore the association between rs7049105, rs647188, rs1333035 and the LAS among patients with evidence of cephalic and cervical vessel atherosclerosis. Methods The present study com?prised 229 LAS patients and 233 healthy controls. The 233 controls which we defined control group 1. In the controls, 150 (64.38%)controls with evidence of atherosclerosis were defined as control group 2, 83(35.62%)controls without evidence of atherosclerosis were defined as control group 3. The sample genotyping was detected using MALDI-TOF-MS. Results There was no polymorphism of rs647188 among case group and control group 1. There was no significant difference in the polymorphism distribution of rs7049105 and rs1333035 between the case group and control group 1 and 3 (P>0.05). There may be no significant different in the polymorphism distribution of rs7049105 between the case group and control group 2 . The rs1333035 was associated with risk of LAS among patients with evidence of cephalic and cervical vessel atherosclerosis (χ2=6.502,P=0.039). Conclusions The rs10757274 and rs7049105 polymorphism in the chromosome 9p21 may not be as?sociated with risk of LAS among Han population of Changsha. There may be no polymorphism of rs647188 among Han popu?lation of Changsha. The rs1333035 polymorphism may be associated with plaque rupture and thrombosis.
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Objective To investigate the effect of bronchodilators on dyspnea and pulmonary function in patients with chronic obstruction pulmonary disease (COPD) at different degrees.Methods 50 patients with COPD from January 2014 to January 2015 in pneumology department of Tongchuan City People's Hospital were selected.According to the standard of Global initiative for chronic obstructive lung disease (GOLD), the patients were divided into mild degree of 14 cases, moderate degree of 18 cases and severe degree of 18 case.The changes of Borg score of dyspnea, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and inspiratory capacity (IC) after received tiotropium bromide inhalation in each group.Results FEV1, FVC, PEF and IC values significant improved in mild, moderate and severe degree groups after received tiotropium bromide inhalation and the values of improvement rate changed significantly with degrees of disease ( P <0.05 ).The improvement rates of FEV1, FVC and IC were highest in patients at severe degree, improvement rate of PEF was highest in patients at mild degree (P<0.05).After received tiotropium bromide inhalation, the Borg score improved significantly compared with that of pre-treatment in mild, moderate and severe degree groups (P<0.05), the improvement rate of Borg score was highest in severe degree group(P<0.05).There were significantly positive correlations between Borg score and FEV1(r=0.372),FVC(r=0.296),PEF(r=0.284),IC(r=0.704)(all P<0.05).Conclusion Bronchodilator could significantly improve dyspnea and lung function in patients with COPD, and the improvement rate of FEV1, FVC and IC is highest in patients with COPD at server degree, PEF is highest at mild degree and Borg score is highest at server degree, which need the comprehensive analysis of each indicators for reversibility of airflow obstruction.
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Objective To report the clinical and magnetic resonance imaging(MRI)features of 5 eases with idiopathic orbital myositis.Methods Four females and one male,aged 27 to 57 years,presented department of neurology in the First Hospital of Peking University in October 2008 to September 2009.The duration of disease Was between 3 months and 4 years.Recurrent course appeared in 3 of them.0rbital MRI Was performed in all of them.After diagnosis they underwent long.term corticosteroid treatment.Results All patients presented ocular pain,asymmetrical and incomplete ophthalmoplegia and mild proptosis.EMG revealed no significant decline in repetitive stimulation.Muscle biopsies of limb muscle were unremarkable.Creatine kinase and thyroid function test were in normal limits.MRI revealed unilateral.focal or difluse enlargement and enhancement of extraocular muscles,involving 1 extraocular muscle in 2 cases,2extraocular muscles in 2 cases,more extraocular muscles in 1 case.No evidence indicated bone destruction or cavernous sinus abnormalities.Five Cases showed improvement and remission after long-term administration of steroids.Conclusion Persistent and asymmetrical ophthalmoplegia is connnon in orbital myositis.Extraocular muscle swelling characterized the MRI changes.
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Objectives To report the clinical and myopathological features in a case with Danon disease caused by a novel mutation in the lysosome-associated membrane protein-2 ( LAMP2 ) B gene.Methods A 16-year-old boy presenting progressive muscle weakness and atrophy, accompanied with spinal ankylosis was clinically evaluated including electrocardiogram, echocardiogram and electromyogram.Muscle biopsy was carried out in the patient.The histological staining, ultrastructural examination, and immunohistochemical staining with antibodies against dystrophin, merosin and C5b9 were performed in frozen sections.LAMP2B sequence was analyzed in the patient and his parents.Results Electrocardiogram in the patient showed Ⅰ atrioventricular block; echocardiogram revealed focal hypertrophy in mitral valve with mild cardiac diastolic dysfunction; electromyogram indicated myogenic and neurogenic patterns.Muscle pathology study revealed numerous vacuoles located at the fibers.Dystrophin, merosin and C5b9 was immuno-positive around the vacuoles.Electron microscopy revealed vacuoles surrounded by sarcolemma and abnormal lysosome aggregating at the fibers.A novel nonsense mutation ( K402X ) in the LAMP2B gene has been identified in the patient but not in his mother and 50 normal controls.Conclusions Danon disease caused by K402X mutation in C-terminus of LAMP2B presented benign course of the disease characterized by prominent vacuolar skeletal myopathy, mild cardiac abnormalities and peripheral neuropathy.
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Objective To investigate the expression and significance of survivin and CD44v6 in non-small cell lung cancer (NSCLC) and their correlation. Methods SP immunohistochemical technique was used to detect the expression of survivin and CD44V6 protein in 53 cases of NSCLC and 13 cases of para-eaneer nor-mal tissues. Results The positive rate of survivin and CD44v6 in NSCLC was 60. 38% and 69. 81% respec-tively,which was higher than that of normal pulmonary tissues adjacent to carcinoma(P <0. 01). The expres-sion of survivin and CD44v6 in NSCLC was related to lymph node metastasis (P < 0. 05), but not to patients' age and gender(P>0.05). The expression of survivin was related to TNM stages and cell differentiation (P <0. 05) ,but not to histology type(P >0. 05). The expression of CD44v6 in squamous carcinoma was significantly higher than that of adenocareinoma (P <0. 05),but the expression of CD44v6 was not related to TNM stages and cell differentiation (P >0. 05). There was no correlation between the expression of survivin and C1)44v6 (r = -0. 058, P >0. 05). Conclusion Survivin might be used to evaluate NSCLC development;CD44v6 might be used for the differential diagnosis of squamous carcinoma in NSCLC;both of them might be helpful to predict the metastasis of NSCLC. They might be two independent events in the process of NSCLC genesis and develop-ment.
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Objective To evaluate the control status and knowledge level about disease in asthmatic patients in region level cities of Shaanxi province for effect appraisal of patient education.Methods Eight hospitals were selected from six region level cities, where questionnaire survey was completed in out-patients with asthma (≥ 14 years old).Results A total of 523 patients completed the questionnaire with a ratio of male to female of 1: 1.14,and an average age of (44.3±15.5) years old.The percentage of controlled, partly controlled and uncontrolled by self-evaluation was respectively 26.4%, 52.4% and 11.1%.48% insisted on using inhaled corticosteroids (ICS).The average score was 17.88±4.43 by asthma control test (ACT).The first three medicines used daily were ICS (26.6%), sustained-release theophyline (25.2%) and combination ICS/long-acting β2-agonists (21.8%).12.6% had no medicine and 5.2% used non-orthodox medicines.68.6% patients had omen before exacerbation, and those were sneezing, chest distress and cough.73.6% knew asthma is a disease of airway inilammatian,and 33.3% selected ICS as the leader medicine.Only 32.1% attended the lecture about asthma in hospitals and 85.0% longed for such education.Conclusions The control status and knowledge level about disease in asthmatic patients in cities still need to be improved in Shaanxi province, and too much work need to be done in order to realize the total control in all patients.
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Objective To evaluate the diagnostic value of transbronchial lung biopsy (TBLB) via bronchoscope for lung diffuse lesions and peripheral pulmonary lesions. Methods The results of TBLB were retrospectively analyzed from 256 diagnoses of unknown patients with lung diffuse lesions or peripheral lung lesions. Results Eighty-nine final diagnosis cases via TBLB only once, the diagnostic rate of double lung diffuse lesions was the highest, [51.06% (24/47)], local non-nodule lesions, nodule lesions, cavity lesions were 33.33%(23/69), 29.91%(35/117), and 28.57%(4/14), respectively. Among 24 diagnostic cases of double lung diffuse lesions, there were 6 cases of pneumonia of pulmonary tuberculosis, 9 cases of lung carcinoma, 7 cases of adenecarcinoma; 6 cases of pneumonia, 2 cases of fungous infection, and 1 case of lung hemosiderusis. The diagnostic yield about 58 cases of local lesions was low, among which non-nodule lesions accounted for 33.33% and nodule lesions accounted for 29.91%. In 89 cases of peripheral lung lesions with histological diagnosis, lung carcinoma and pulmonary tuberculosis were frequent diseases, which accounted for 86.52%. Conclusion TBLB is a reliable, safe, effective and repeatable operation method in diagnosis of lung diffuse lesions and peripheral pulmonary lesions.
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Objective: To evaluate the diagnostic value of transbronchial lung biopsy (TBLB) via bronchoscope for lung diffuse lesions and peripheral pulmonary lesions. Methods: The results of TBLB were retrospectively analyzed from 256 diagnoses of unknown patients with lung diffuse lesions or peripheral lung lesions. Results: Eighty-nine final diagnosis cases via TBLB only once, the diagnostic rate of double lung diffuse lesions was the highest, [51.06%(24/ 47)], local non-nodule lesions, nodule lesions, cavity lesions were 33.33%(23/69), 29.91%(35/117), and 28.57% (4/14), respectively. Among 24 diagnostic cases of double lung diffuse lesions, there were 6 cases of pneumonia of pulmonary tuberculosis, 9 cases of lung carcinoma, 7 cases of adenocarcinoma; 6 cases of pneumonia, 2 cases of fungous infection, and 1 case of lung hemosiderosis. The diagnostic yield about 58 cases of local lesions was low, among which non-nodule lesions accounted for 33.33% and nodule lesions accounted for 29.91%. In 89 cases of peripheral lung lesions with histological diagnosis, lung carcinoma and pulmonary tuberculosis were frequent diseases, which accounted for 86.52%. Conclusion: TBLB is a reliable, safe, effective and repeatable operation method in diagnosis of lung diffuse lesions and peripheral pulmonary lesions.
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OBJECTIVE:To investigate the pharmacoeconomic efficacy of four chemotherapeutic schemes for advanced non-small cell lung cancer in elderly patients.METHODS:92 elderly patients with advanced non-small cell lung cancer were randomly divided into four groups:GP,NP,PC,and TP groups.The pharmacoeconomic efficacy of the four groups was analyzed and evaluated retrospectively using the cost-minimization analysis in pharmacoeconomics.RESULTS:The costs of GP,NP,PC,and TP schemes were 10 820.69 yuan,5 864.54 yuan,7 595.57 yuan,and 7 774.64 yuan,respectively(P0.05),respectively.The adverse drug reactions were characterized by different degree of myelosuppression and gastrointestinal reactions,all were cured on symptomatic treatment.CONCLUSION:The cost-minimization analysis showed that NP scheme is the optimal one of the four schemes.
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Objective To clarify the possible role of cyclooxygenase-2(COX-2), intercellular adhesion molecule-1(ICAM-1) and E-selectin in the inflammatory injury induced by cerebral ischemia and reperfusion. Methods The focal cerebral ischemia and reperfusion model was induced by a suture occlusion of the right middle cerebral artery. The rats were randomly assigned to four groups: sham operated group; 4 h,22 h and 46 h reperfusion groups. The expression of ICAM-1, E-selectin and COX-2 were detected by immuno-Western blot and immunohistochemical method. Myeloperoxidase (MPO) activity was detected by a commercial MPO kit. Results In the right cortex and striatum of the sham operated group and the 4 h, 22 h and 46 h reperfusion groups, the relative values of COX-2 were 0.7642?0.0763, 1.5382?0.1047, 1.6491?0.3265, 1.8020?0.3719 and 0.7104?0.0891, 2.2061?0.2143, 1.7897?0.3537, 1.8018?0.5703 respectively; the relative values of ICAM-1 were 0.6845?0.0531, 0.9115?0.0422, 0.9426?0.0407, 1.0756?0.0467 and 0.6583?0.0361, 0.9439?0.0746, 0.9975?0.1532, 0.8808?0.0497 respectively. Significant increase of MPO activity and expression levels of COX-2, ICAM-1 and E-selectin were shown from 4 h to 46 h in the striatum and cortex of rats following reperfusion. Immunohistochemical staining showed that the number of ICAM-1 and E-selectin positive vessels was increased in the border of ischemia. The positive cells of COX-2 were almost neurons in the cortex, but in the striatum, the cells were neurons, glias and vessel endothelium. Positive correlation between COX-2 and ICAM-1 expression in the cortex(n=6,r=0.973,P