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According to WHO, one of these mass gatherings with critical risk is stampedes. Shanghai "12.31" stampede was a preventable tragedy that the government and event planner hold responsibility for. At the same time, it can be a legacy for improvement in the future. The government should draw experience on the implementation of an emergency preparedness system, in order to improve the rapid emergency response during mass gatherings in the future.
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Objective: To analyze associations of MRI-lesions and clinical features with disability in patients with multiple sclerosis (MS) in Shanghai, China. Methods: We studied patients with MS, identified from a survey in Shanghai, whose sites of lesions in the CNS was based on the MRI examinations. Associations between MRI-lesions, various clinical variables and the severity of disability were analyzed with univariate and multivariate logistic regression analysis. Results: There were 210 patients in this study. The disability of the patients with lesions confined to the spinal cord was significantly more severe than those with lesions in the brain (p < 0.008). Current age (OR: 1.041, 95% CI: 1.007~1.077), MS duration (OR: 1.082, 95% CI: 1.011~1.159) and MRI-lesions in the spinal cord (OR: 2.441, 95% CI: 1.039~5.737) were significantly associated with severity of disability on multivariate logistic regression analysis. Conclusion: MRI-lesions in the spinal cord, older age, a longer MS duration were significantly associated with a more severe disability in this MS study in Shanghai China.
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<p><b>OBJECTIVE</b>To explore the clinical features of horizontal semicircular canal benign paroxysmal positional vertigo.</p><p><b>METHODS</b>The clinical manifestations of 239 patients with horizontal semicircular canal benign paroxysmal positional vertigo from August 2003 to December 2010 were retrospectively analyzed.</p><p><b>RESULTS</b>25.7% (239/931) of all the benign paroxysmal positional vertigo patients were the horizontal semicircular canal benign paroxysmal positional vertigo was involved. One hundred and ninety-seven patients showed geotropic nystagmus in head rolling test with a mean latency period of (0.88 ± 0.72) s and a mean duration period of (26.36 ± 19.71) s. Forty-two patients showed apogeotropic nystagmus in head rolling test with a mean latency period of (2.69 ± 1.83) s and a mean duration period of (53.48 ± 43.12) s. Among all the horizontal semicircular canal benign paroxysmal positional vertigo patients, 39 (16.3%) presented horizontal nystagmus with slight upbeating component. The nystagmus latency in apogeotropic nystagmus group was longer than that in geotropic nystagmus group (t = -6.33, P < 0.001), and nystagmus duration period was also longer (t = -3.99, P < 0.001). Applied Barbecue maneuver to the patients with geotropic nystagmus, 192 patients were cured after (1.6 ± 0.8) rotations; After applied head shaking maneuver to the patients with apogeotropic nystagmus, 40 patients changed to geotropic nystagmus and cured after (1.9 ± 0.8) rotations.</p><p><b>CONCLUSIONS</b>Incidence rate of horizontal semicircular canal benign paroxysmal positional vertigo was higher than expectation. Barbecue maneuver was applied to patients with geotropic nystagmus. While to the patients with apogeotropic nystagmus, head shaking maneuver should be performed firstly and then followed by Barbecue maneuver.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Benign Paroxysmal Positional Vertigo , Nystagmus, Pathologic , Retrospective Studies , Semicircular Canals , Vertigo , Diagnosis , TherapeuticsABSTRACT
Subjective and objective measures of sleep structure or quality could help to characterize the chronic sleep disturbances, with relation to patients' risk factor profiles and co-morbidities. Studies have shown that discrepancies can occur between subjective data regarding sleep disturbances and the impact of insomnia and objective assays, and surrogate markers of sleep and sleep disturbances. Both objective and subjective measures should be incorporated into clinic studies. It seems likely that sleep quality is represented by a combination of more than one subjective sleep parameter. Objective and subjective assessments of sleep quality may relate to different parameters. Future studies incorporated both subjective and objective measures could help to address the sleep disorders.
Subject(s)
Humans , Electroencephalography , Polysomnography , Methods , Quality of Life , Sleep Wake Disorders , Diagnosis , Psychology , Sleep, REM , Physiology , Weights and MeasuresABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical features and therapy of subjective benign paroxysmal positional vertigo (S-BPPV).</p><p><b>METHODS</b>By retrospectively analyzing the results of clinical features and therapy in 12 patients with S-BPPV from January 2003 to September 2006, the results were compared with 24 patients with objective benign paroxysmal positional vertigo (O-BPPV) of posterior semicircular canal.</p><p><b>RESULTS</b>S-BPPV patients suffered from attack of transient vertigo with sudden onset triggered by head motion but no concomitant nystagmus in Dix-Hallpike test. The latency and duration of vertigo attack were (4.42 +/- 2.02) s and (8.67 +/- 4.31) s in S-BPPV, (3.2 +/- 1.18) s and (14.75 +/- 4.97) s in O-BPPV of posterior semicircular canal. The differences between the two groups were all significant (t = 2.30, P < 0.05 and t = 3.61, P < 0.01). The symptoms disappeared in 11 patients after a single therapy of particular repositioning maneuver and 1 patient after 2 times therapy in S-BPPV. The one-stage success rate was 91.7% in S-BPPV and 79.2% in O-BPPV of posterior semicircular canal, but the difference between these two groups was not significant. The number of circulation therapy in first management was (1.75 +/- 1.08) times in S-BPPV and (3.38 +/- 1.06) times in O-BPPV of posterior semicircular canal, while the difference was significant (t = 4.32, P < 0.01). There were 2 patients recurred during follow-up in S-BPPV and 7 patients in O-BPPV of posterior semicircular canal, but the difference wasn't significant.</p><p><b>CONCLUSIONS</b>Longer latency, shorter duration and need less circulation therapy are achieved in S-BPPV compared with O-BPPV of posterior semicircular canal, which indicate that the effectiveness of S-BPPV seems to be more favorable than that of O-BPPV of posterior semicircular canal.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Retrospective Studies , Semicircular Canals , Treatment Outcome , Vertigo , Diagnosis , TherapeuticsABSTRACT
Objective To investigate the changes of expression of neuronal nitric oxide synthase(nNOS) after sleep deprivation(SD) in rats,and to study the effects of Xingnaojing on them. Methods Rapid eye movement(REM) SD models(SD group,n=40) were established by the modified multiple platform methods.The rats in SD group were subjected to drug intervention group(n=20) and non-drug intervention group(n=20).Xingnaojing injection was administered to the drug intervention group.Rats in SD group were deprived of sleep for 1,3,5 and 7 d. The expression of nNOS in brain tissues was detected by immunohistochemistry.The rats without SD were severed as cage control group(n=10) and tank control group(n=10). Results The expression of positive cells of nNOS in brain tissues increased with the time of SD,and Xingnaojing decreased the number of positive cells of nNOS.The area density of positive reaction cells in SD group was significantly higher than those in cage control group and tank control group(P
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Synapsins are a family of phosphoproteins specifically associated with the cytoplasmic surface of the synaptic vesicle membrane, appearing to regulate neurotransmitter release, the formation and maintenance of synaptic contacts. They could induce the change of the synaptic plasticity to regulate various adaptation reactions, and change the cognitive behaviors. So we presume that if some cognitive behaviors are damaged, synapsins would be changed as well. This gives us a new recognition of better diagnosis and therapy of cognitive disorder disease.
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Objective To evaluate the chnical features and prognosis of traumatic benign paroxysmal positional vertigo (t-BPPV).Methods By retrospectively analyzing the results of clinical features and prognosis in 19 patients with t-BPPV from January 2003 to September 2006,the results were compared with 51 patients with idiopathic benign paroxysmal positional vertigo (i-BPPV).Results The mean ages were (51.3?19.1) years in t-BPPV group and (63.2?16.5) years in i-BPPV group,the difference was significant (t=2.57,P0.05).The one-stage success rates were 62.5% in t-BPPV group and 83.6% in i-BPPV group,the difference was significant (x~2=4.94,P
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Objective To evaluate the therapeutic effects and safety of amitrine bismesylate in patients with mild vascular dementia.Methods An open multicenter self-controlled trial was carried out with 128 mild vascular dementia patients clinically diagnosed.Patients were treated with amitrine bismesylate in a dose of 2 tablets per day for 12 weeks.The neuro-psychologieal scale of MMSE,ADAS-cog,CDR, ADL were used to evaluate patients′cognitive condition before therapy and 6,12 weeks after treatment.The adverse effects,such as nausea and vertigo and so on,were monitored at the same time to evaluate the safety of this drug.Results After 3 months of treatment,the MMSE score(16.98 before therapy and 17.97 after treatment,P
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Objective: To investigate the circadian ryhthm v ariation of 2-125I-iodomelatonin (125I-Mel) binding sites in the human peripheral leukocytes in patients with acute cerebral infarction. Methods: Melatonin binding sites in the human peripheral leukocytes were studied using 125 I-Mel as a radioligand (radioligand binding assays).A ll patients ［age: (70.18±11.70) years］ were diagnosed by CT according to the standard ［Chin J Nerv， 1996,29(6):379］. We also studied 15 age-match ed healthy old people as the control ［age: (68.33±7.76) years］. Resul ts: The circadian ryhthm variation of 125 I-Mel specific binding in control remained significant (P<0.01) with a higher value at midlight ［ (0.16±0.049) fmol/106］ than at middark ［(0.078±0.035) fmol/106］ with one point analysis. There was no significant variation in the patient grou p (P>0.05). The specific binding in the peripheral leukocytes at midlight in the patients with acute cerebral infarction were lower than that of the control . Conclusion: The expression of Mel receptor decreases in the pa tients wit h acute cerebral infarction and the circadian ryhthm variation of 2-125I -Mel appears abnormal.
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Objective: To investigate the circadian ryhthm v ariation of 2-125I-iodomelatonin (125I-Mel) binding sites in the human peripheral leukocytes in patients with acute cerebral infarction. Methods: Melatonin binding sites in the human peripheral leukocytes were studied using 125 I-Mel as a radioligand (radioligand binding assays).A ll patients ［age: (70.18±11.70) years］ were diagnosed by CT according to the standard ［Chin J Nerv， 1996,29(6):379］. We also studied 15 age-match ed healthy old people as the control ［age: (68.33±7.76) years］. Resul ts: The circadian ryhthm variation of 125 I-Mel specific binding in control remained significant (P<0.01) with a higher value at midlight ［ (0.16±0.049) fmol/106］ than at middark ［(0.078±0.035) fmol/106］ with one point analysis. There was no significant variation in the patient grou p (P>0.05). The specific binding in the peripheral leukocytes at midlight in the patients with acute cerebral infarction were lower than that of the control . Conclusion: The expression of Mel receptor decreases in the pa tients wit h acute cerebral infarction and the circadian ryhthm variation of 2-125I -Mel appears abnormal.
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Objective To investigate the impact of rapid eye movement (REM) sleep on the rat brain.Methods Microtubule-associated protein 2 (MAP2) and neurofilament (NF) were used as two neuronal cytoskeleton markers.The modified multiple platform method (MMPM) was used to deprived rats of sleep.The immunohistochemistry method and Western blot technique were used to detect the expression of MAP2 and NF,together with the electromicroscope study to show the neurodegeneration in rat cerebral cortex and hippocampus.Results The expression of MAP2 and NF in cerebral cortex and hippocampal neurons decreased after 5-day sleep deprivation.Some uhrastructural changes were seen in those areas as well,such as displacement of the nucleus,slightly swollen mitochondrial and endoplasmic reticulum,dissolution or condensation of sheaths of some axons.Neurons in cortex with degenerated ultrastrutrue accounted for 1.2% ,3.6% and 5.8% in tank control group,sleep deprivation 5 d group and sleep deprivation 7 d group respectively.Conclusion REM sleep deprivation can induce neurodegeneration in rat brain,but these morphological changes are tiny enough to be considered as reversible.
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Sleep plays an important role in the modulation of endocrine function and energy metabolism;hormone levels are markedly different during a sleepless night compared with a night of normal sleep.Sleep deprivation may change the levels of cortisol,growth hormone(GH)and thyrotropin(TSH)at night.In addition,sleep curtailment disturbs the balance of anorexi- genic(leptin)and orexigenic(ghrelin)factors,and does harmful to glucose tolerance.
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Sleep is a common physiological phenomenon of animals.We may have different kinds of sleep disorders in our daily life,such as difficulty falling asleep,insomnia,hypersomnia and changes of sleep patterns,etc.Pain is a subjective response of the body to stimuli of certain degrees.Sleep disorders are closely related to pain:pain can interfere with people's normal physiology and psychology conditions and affect individual's sleep;different kinds of sleep disorders can affect the body' s sensitivity to pain.The relationship between pain and sleep disorders has become one of the most common causality in clinical research.In this paper we summarizes the pathophysiological relation and mutual influence between pain and sleep disorders.
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Objective: To investigate the changes of adhesion molecules in peripheral blood in patients with recurrent cerebral infarction. Methods: By cytometry and enzyme-linked immunosorbent assay, the expression of integrin Mac-1 ?-sub-unit(CD18) ,intercellular adhesion molecule-3(CD50) intercellular adhesion molecule-1 (CD54) ,very late antigen-4 ?-subunit and p-subunit(CD49d and CD29),CD44 and L-selectin(CD62L) in lymphocyte,the expression of platelet membrane glycopro-tein I b- I a complex a-subunit (CD41), P-selectin (CI)62p) ,the serum level of soluble P-selectin(sP-selectin) and soluble intercellular adhesion molecule-1 (sICAM-1) were measured in 33 recurrent cerebral infarction patients and 44 patients with previous ever-single cerebral infarction history. Results: Compared with previous ever-single cerebral infarction history patients, the positive percentage of CD18,CD50,CD54 ,CD49d,CD29,CD44 and CD62L in lymphocytes ,CD41 on platelet did not significantly change,while the positive percentage of CD62p on platelet and the level sP-selectin,sICAM-1 were significantly higher (P