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Objective To investigate the prevalence of metabolic syndrome in patients with maintenance hemodialysis, and to analyze the potential risk factors. Methods The clinical data of 472 patients with maintenance hemodialysis from 7 blood purification centers were collected. Patients were divided into the MS group and the non-MS group. The demographic data , anthropometric examinations , dialysis prescription and results of laboratory were compared between these two groups. Multivariate Logistic regression analysis was performed to analyze the risk factors of MS. Results The morbidity of MS was 34.75%. There were significant differences in weight , waist circumference , waist-hip ratio , frequency of dialysis , time of hemodialysis perweek , urea reduction ratio, urea clearance index (Kt/v), iron, intact parathyroid hormone (iPTH), leukocytes, high sensitivity C-reactive protein (hs-CRP) between these two groups (P < 0.05, resectively). Multivariate Logistic regression analysis revealed that iron (OR = 1.084, P = 0.042), iPTH (OR = 1.754, P = 0.035), waist-hip 1ratio (OR = 2.013,P = 0.021), hs-CRP (OR = 4.245,P = 0.000)were correlated with MS. Conclusion The morbidity of MS in patients with maintenance hemodialysis is higher. Iron, iPTH, waist-hip ratio, hs-CRP are potential risk fctors of MS for the patients with maintenance hemodialysis.
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Objective To investigate the time and rate of generalization developed from ocular symptoms in adults to generalized myasthenia gravis (GMG).Methods The data from 456 adult patients who started on ocular symptoms during Jan 2005 to Jan 2012 were retrospectively studied,with a follow-up period of 3 months to 17 years.The data included transfer time,Osserman type,difference between steroids group and no-steroids group.Results (1) During the follow-up period,197 (43.2％) patients developed to generalized myasthenia gravis,58.4％ (115/197)in one year after onset of ocular symptoms,74.1％ (146/197) in 2 years and 80.7％ (159/197) in 3 years.86.8％ (171/197) developed to Osserman Ⅱ a or Ⅱ b.(2) Of 233 patients untreated with steroids,134 (57.5％) developed to GMG,while 63 (28.3％) of 223 patients who were treated with steroids developed to GMG (x2 =38.57,P ＜ 0.01).There were no difference between two groups in transfer time and Osserman type.Conclusion MG initiated from ocular syndromes in adults easily develops to GMG in 2 years.Patients treated with steroids have low chance of generalization.
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Objective To analyze the symptoms and signs in forty-five Lambert-Eaton myasthenia syndrome (LEMS) patients retrospectively. Characteristics of electrophysiological examinations were investgated. Methods Forty-five LEMS patients were reviewed and information gathered regarding clinical complains neurological symptoms, and other concomitant diseases. The records showed that repetitive nerve stimulation (RNS) and nerve conduction velocity (NCV) were performed in all patients. Needle electromyography (EMG) and skin sympathetic response (SSR) were performed in some patients. Results (1) The mean age of neurological clinical onset age was (51.2 ±6. 8) years old. The two most common symptoms were slight weakness of lower extremities ( n = 35 ) and upper extremities (n= 5). Dysarthria was found in 3 patients and neck weakness in 2 patients. Tendon reflex decreased and disappeared in 38 patients. Autonomic nervous system manifestations were presented in 30 patients. (2) RNS increasing was observed in all patients from 156% to 636%. Low frequency RNS abnormalities were found in 29 patients.Sensory nerve conduction velocity abnormalities or sensory nerve conduction velocity combined motor nerve conduction velocity abnormalities were found in 19 patients ( 42% ). Of the 30 patients who underwent a needle EMG examination, 20 had myogenic or neurological damage. Thirteen abnormal findings were observed in 25 patients who underwent SSR examination. Conclusion The most common manifestations were weakness in lower extremities and autonomic nervous system dysfunction. Many abnormal electrophysiological results were found in LEMS patients, including NCV and EMG abnormalities. These findings indicated that clinical manifestations exceed the neuromuscular junction and perhaps included the peripheral nerve and muscle.