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Objective:To analyze the characteristics of sleep disorders in patients with Parkinson disease (PD) and to explore the relationship between respiratory events and rapid eye movement sleep with hypotonia.Methods:Thirty-nine PD patients compared with 75 controls matched with gender, age and body mass index(BMI) were collected in the Dalian Municipal Central Hospital from January 1, 2019 to September 31, 2019. Both groups underwent polysomnography monitoring. The characteristics of sleep disorders were analyzed and discussed.Results:Apnea and hypopnea index (AHI) during total sleep, AHI during non-rapid eye movement(NREM) sleep, AHI during rapid eye movement (REM) sleep, obstructive apnea index, mixed apnea index, central apnea index, total apnea index, hypopnea index, the time with pulse oximetry <90% and oxygen desaturation index in the PD group were lower than those in the control group: 3.70(0.80, 20.00) /h vs. 17.30(7.30, 28.20)/h, 2.30(0.70, 13.90)/h vs. 15.20(4.90, 27.50)/h, 2.30(0.00, 29.80)/h vs. 16.90(5.70, 39.50)/h, 0.30(0.00, 5.10)/h vs. 3.10(0.50, 7.80)/h, 0.00(0.00, 0.20)/h vs. 0.20(0.00, 0.60)/h, 0.00(0.00, 0.30)/h vs. 0.30(0.00, 0.80)/h, 0.70(0.00, 6.00)/h vs. 3.90(0.80, 10.70)/h, 1.70(0.50, 8.90)/h vs. 8.70(2.70, 14.90)/h, 0.00(0.00, 0.40)min vs. 0.20(0.00, 1.70)min, 4.10(1.10, 18.40)% vs. 16.50(9.30, 30.80)%, and the differences were statistically significant ( P<0.05). The mean pulse oximetry and minimum pulse oximetry in the PD group were higher than those in the control group: 96.00(95.00, 97.00)% vs. 95.00(94.00, 96.00)%, 89.00(82.00, 91.00)% vs. 85.00(81.00, 89.00)%, and the differences were statistically significant ( P<0.05). PD group was divided into PD with RSWA group (PD + RSWA) and PD without RSWA group (PD-RSWA) according to whether there was atonia or not. AHI during REM sleep in the PD+RSWA group was lower than that in the PD-RSWA group: 0.00(0.00, 5.40)/h vs. 5.75(0.52, 34.57)/h, and the difference was statistically significant ( P<0.05). Conclusions:PD has a protective effect on nocturnal respiratory events, which may be due to the increased muscle tone of upper airway.
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Objective:To compare the efficacy of superior trunk block (STB) versus interscalene brachial plexus block (ISB) in the patients undergoing arthroscopic shoulder surgery with general anesthesia.Methods:Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 18-70 yr, undergoing elective arthroscopic shoulder surgery, were divided into 2 groups ( n=30 each) using a random number table method: ISB plus general anesthesia group (group IG) and STB plus general anesthesia group (group SG). In group IG and group SG, 0.375% ropiacaine 15 ml was injected around C 5-C 6 nerve roots and superior trunk, respectively.SpO 2, diaphragmatic excursion, diaphragmatic paralysis, dyspnea and Horner syndrome were recorded at 30 min after injection.General anesthesia with tracheal intubation was then performed in all the patients, and remifentanil or phenylephrine was used to maintain hemodynamics stable.The use of remifentanil was recorded at the end of operation, the visual analogue scale score was performed after patients regained consciousness, and the duration of sensory and motor blockade was recorded at 24 h after operation. Results:Compared with group IG, the decrease in the amplitude of SpO 2 was significantly decreased, and diaphragmatic excursion was increased, the incidence and degree of diaphragmatic paralysis were decreased, duration of sensory blockade was prolonged, the incidence of Horner syndrome and dyspnea was decreased ( P<0.05), and no significant change was found in the requirement for remifentanil, postoperative visual analogue scale score, and duration of motor blockade in group SG ( P>0.05). Conclusion:STB not only provides better perioperative analgesia, but also reduces the incidence of diaphragmatic paralysis when compared with ISB in the patients undergoing arthroscopic shoulder surgery with general anesthesia.
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Objective To determine the effectiveness and medical cost-effectiveness of clinical rehabilitation for promoting the functional recovery of sub-acute cerebral infarction patients.Methods Totally 247 sub-acute patients with cerebral infarction were randomly divided into a clinical rehabilitation group of 129 and a routine rehabilitation group of 118.The clinical group received a standardized rehabilitation intervention and drug treatment,while the routine rehabilitation group received routine rehabilitation therapy and drug treatment.The Fugl-Meyer assessment (FMA) and the modified Barthel index (MBI) were used to compare the two groups after the treatment and 3 and 6 weeks later.The hospital cost for six weeks was also compared between the 2 groups.Results At 3 and 6 weeks,improvement in the average FMA and MBI scores was observed in both groups but the inter-group differences were not significant.The total hospital cost of the clinical group was,however,significantly less than that of the others.Conclusion Clinical rehabilitation can improve the motor function and ability in the activities of daily living of stroke patients.It also has economic benefits.
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Objective To explore the influence of autophagy on lipopolysaccharide (LPS) induced acute lung injury (ALI) . Methods Forty‐eight Sprague Dawley (SD) rats were randomly divided into four groups ,12 cases in each group :(1)normal saline control group (NS) ,(2)LPS model group (L) ,(3) LPS and autophagy group (L +A) and (4) LPS and autophagy inhibition group (L+I) .Arterial blood samples was obtained for detecting the blood gas ,including PaO2 ,PaCO2 and pH ,and the lung tissue dry/wet ratio was calculated .The HE staining was used to observe the histopathological changes of lung tissue .Moreover the lung le‐sion score was performed ;the expression of microtubule associated protein ,light chain protein 3b(LC3b) ,myeloperoxidase(MPO) , macrophage inflammatory protein 2(MIP‐2) ,interleukin‐1β(IL‐1β) and tumor necrosis factor‐α(TNF‐α) in serum and bronchoalve‐olar lavage fluid(BALF) was assessed by ELISA .Results Compared with the NS group ,arterial blood PaO2 and pH in the group L were decreased and PaCO2 was increased (P<0 .05);compared with the L group ,the arterial blood PaO2 and pH in the L+A group were increased and PaCO2 was declined (P<0 .01) ,the arterial blood PaO2 and pH in the L+ I group were decreased and PaCO2 was elevated ,the differences were statistically significant (P<0 .01) .The LC3b concentration in serum and BALF in the L group and L+I group was declined ,while MPO ,MIP‐2 ,IL‐1βand TNF‐αconcentrations were increased ,while which in the L+ A group were just the opposite .Conclusion Autophagy plays a improvement and protective effect on LPS induced acute lung injure in rat .