Gender Was Associated with Depression but Not with Gastrointestinal Dysfunction in Patients with Parkinson's Disease.

OBJECTIVE: To investigate the association between gender and gastrointestinal (GI) dysfunctions, as well as gender and other motor symptoms/nonmotor symptoms, in a sample of PD patients. METHODS: 186 patients with PD were recruited into this study and divided into male PD group (M-PD) and female PD group (FM-PD). Demographic and PD-related clinical information of the participants were collected by the same neurologist. PD patients were objectively assessed by a spectrum of rating scales of motor symptoms and nonmotor symptoms (including GI dysfunctions). The data were analyzed by SPSS 20 statistical software. RESULTS: Totally 95 cases (51.08%) were in the M-PD group and 91 cases (48.92%) in the FM-PD group. There were no significant differences in age, BMI, and lifestyles between the two groups (P > 0.05). Males had higher educational level (P = 0.002). Females were more likely to have early satiety and loss of appetite (P = 0.025, P = 0.001). There were no significant differences in LED disease duration, age of motor symptoms onset, types of motor symptoms onset, location of motor symptoms onset, and phenotype of motor symptoms between the two groups (P > 0.05). Females had significantly higher UPDRS-III and HAMD scores than males (P = 0.037, P = 0.034). There were no significant differences in PQSI, ESS, RLS, RBD, HAMA, HAMD, and MoCA scores between the two groups. Gender was associated with HAMD (OR = 0.682, P = 0.019). CONCLUSIONS: Gender is a risk factor for depression, but not for GI dysfunctions in patients with PD.

Depression Is Associated With Constipation in Patients With Parkinson's Disease.

Objective: Constipation is one of the most frequent non-motor symptoms (NMS) in Parkinson's disease (PD), causing great disturbance to patients. The present study investigated the prevalence and the clinical features of constipation in patients with PD and explored the difference between prodromal and clinical constipation of PD. Methods: A total of 186 patients with PD were recruited into this study. Subjective constipation was defined by ROME III criteria. Demographic and PD-related clinical information of the participants were collected. The PD patients were objectively assessed by a spectrum of rating scales of motor symptoms, non-motor symptoms, and quality of life. Results: In total, 51.61% (96/186) of PD patients suffer from constipation. Compared with patients without constipation, the patients with constipation were prone to have restless leg syndrome, depression, and anxiety and have higher scores of the non-motor symptoms scale. Among patients with constipation, 21.88% (21/96) patients had constipation in prodromal stage. Compared with patients with constipation in clinical stage, patients with prodromal constipation had a lower age of constipation onset (56.48 ± 9.63 and 65.26 ± 8.42, χ2 = 4.091, P < 0.001), longer timespan from constipation onset to motor symptom onset (6.62 ± 3.91 and 3.18 ± 2.13, χ2 = -3.877, P = 0.001). Patients with prodromal constipation were predominantly tremor onset (χ2 = 4.405, P = 0.044) and usually had a better quality of life [28 (14.50-37.5) and 40 (25.0-55.0), χ2 = 2.011, P = 0.046]. Depression was the only risk factor of constipation in PD patients. Body mass index, depression, and anxiety were factors that affected the life quality in patients with constipation. Conclusions: Our results supported the high incidence of constipation in patients with PD and that, in some patients, constipation occurred before the onset of motor symptoms. The specific clinical characteristics of patients with constipation and with prodromal constipation help to make early diagnosis, to discover the relationship between constipation and PD, and to further explore the pathogenesis of this degenerative disease.

Development of new radial artery puncture and fixation device / 医疗卫生装备

Objective To develop a new radial artery puncture fixing device to conquer the deficiencies of traditional method. Methods The device was composed of an arm support,a hand support,a wrist part,an arm fixing belt,a palm fixing belt and a tourniquet.The arm support was concave-shaped,and was connected with the hand support with the wrist part.The wrist part had a raised block which was gifted with an inflatable bag.The balloon linked with an inflation balloon with an inflation tube.There was a valve between the inflation tube and balloon.The fixing belt had one end directly connected with the arm support, hand support and wrist part, and the other end linked with the other ends of the above components with Velcro. There was a compression hemostatic balloon at the internal surface of the tourniquet. Results The device behaved well in puncture time and success rate,and decreased the incidence rates of errhysis and hematoma after withdrawing the puncture needle while increased the satisfaction of medical staffs and patients. Conclusion The device gains advantages in simple structure,convenience,practicability and safety,and meets the desired requirements.[Chinese Medical Equipment Jour-nal,2018,39(5):44-46]

Development of disposable anticoagulant negative pressure syringe / 医疗卫生装备

Objective To develop a disposable negative pressure syringe to solve the problems in bone marrow aspiration. Methods The syringe was composed of an injector and a self-contained puncture needle.The injector consisted of a barrel,a plunger and a tip.The plunger had its front end placed in the barrel and connected with the tip.The tip clung to the inner wall and could slide along it,and the upper end of the cylinder was connected closely with a negative-pressure sealing cap.A negative-pressure cavity was formed between the sealing cap and the tip,and an anticoagulation layer existed at the cylinder inner wall in the cavity.The blood taking needle was made up of a bone puncture needle and a hub.Results The developed syringe gained stable negative pressure,low time and workload consumption during bone marrow aspiration when compared with the conventional tools. Conclusion The syringe increases the quality of bone marrow aspiration while decreases the workload of medical staffs,and thus is worthy promoting practically.

Laryngeal reconstruction by complex hyoid bone flap after frontal partial laryngectomy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The aim of this study was to describe a new technique of combined hyoid bone and thyrohyoid membrane flap in laryngeal reconstruction after tumor resection, and to evaluate outcome.</p><p><b>METHODS</b>Six patients requiring an frontal partial laryngectomy for cancer were enrolled between September 2008 and August 2012.</p><p><b>RESULTS</b>Nasogastric feeding was initiated within 24 hours. The mean times to swallow batter, ability to drink water and removal of the nasogastric tube were 2.6, 5.5 and 6.3 days. All patients had good respiratory function. There were no deaths, and no reports of postoperative dyspnea or dysphagia. The vocal quality was satisfactory, slightly deeper and raspy, and the volume was weak when calling. The final follow-up assessment was in August 2012, and the overall mean follow-up period was 29.5months, range 14 to 47 months. Case two subsequently underwent total laryngectomy for recurrence in the paraglottic space, but there was no evidence of further tumor recurrence at the final assessment.</p><p><b>CONCLUSIONS</b>The combined muscle-pedicle hyoid bone and thyrohyoid membrane flap is a reliable graft for one-stage repair of laryngotracheal defects, providing effective repair of the mucosa and cartilage support. Vocal quality, swallowing function and ventilation after the procedure were favorable.</p>

Use of a linear stapler device in total laryngectomy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the value of using a linear stapler device for the closure of the pharynx during total laryngectomy.</p><p><b>METHODS</b>Sixteen total laryngectomies were performed between August 2010 and December 2011, during the operation, the TA 60 linear stapler was used for pharyngeal closure. Among these patients, two patients had the history of pre-operative radiotherapy, four patients recurred after radiotherapy, ten patients were treated for the first time. 100 ml methylene blue was injected into the newly closed laryngopharyngeal cavity through the nasopharyngeal breather pipe for checking up whether it was watertight or not.</p><p><b>RESULTS</b>Among the sixteen patients, methylene blue leakage from the mucosal joint of the gular cavity closed by the stapler were not found in fifteen patients, it was only found in one patient. The transudatory places were sutured with absorbable Vicryl sutures. This patient healed well without pharyngocutaneous fistula. Negative surgical margins were achieved in all patients. No patient needed to be transferred to open surgery. Using a linear stapler device in total laryngectomy, 45 minutes could be saved as compaired to manual suture. One patient developed a light pharyngocutaneous fistula. The incidence of pharyngocutaneous fistula was 6.25% (1/16).</p><p><b>CONCLUSIONS</b>This stapled closed technique for pharyngoplasty is efficient, eliminates the risk of wound contamination, saves operation time and decreases the incidence of pharyngocutaneous fistula. This technique can be recommended as alternative for repairing the pharynx in patients undergoing total laryngectomy.</p>