Objective To investigate the characteristics of arrhythmias and the efficacy and safety of oral amiodarone in uremic cardiomyopathy complicated with severe ventrieular arrhythmias.Methods 86 patients with uremic cardiomyopathy underwent ECG,ambulatory ECG and and echocardiograplly.45 of 86 palients with severe ventricular arrhythmias were orally given amiodarone(0.2g,tid×5d,0.2g,bid×5d,maintenance dose 0.2g,qd),ambulatory,ECG was followed up 10 days after amiodarone loading.Results Arrhythmias was detected in 62 of 86 patients with uremic cardiomyopathy,56 of 62 had ventricular arrhythmias,45 of 56 patients with vemricular arrhythmias was defined as severe because of frequent(＞30/h)or repetitive(＞5 couplets/24h or＞1 salvos of or＞3).48 of 62 patients were supraventrieular arrhythmias.Ventricular arrhythmias were sigrtificantly reduced in 45 partients on amiodarone treatment,28 of 45 patients were significant effective and 13 of 45 cases were effective,the efficacy is 91.1%.Systolic blood pressure and heart rate were not changed significantly after 10-day amiodarone reatment compared with that of untreatment.Only one patients experienced sinus bradycardia(45～55 beats per minute)and swspended after discontinuation of oral amiodarone.Conclusion In patients with uremic cardiomyopathy,arrhythmias were common on ambulatory recording,oral amiodarone was effective and safe for patients with severe ventricular arrhythmias.

Objective To investigate the prevalence,clinical traits and correlates of apathy in patients with Parkinson' s disease ( PD ).Methods Seventy-seven cases of PD patients and 40 health controls were recuited in the present study.Apathy was assessed using Lille Apathy Rating Scale(LARS) and related factors,such as motor function,cognition,depression,age,sex,education level,disease duration,levodopa equivalent doses (LED) and use of antipsychotic drugs were also evaluated.Four kinds of scales,Unified Parkinson' s Disease Rating Scale (UPDRS),Hoehn-Yahr staging,Montreal Cognitive Assessment (MoCA),Hamilton Depression Rating Scale (HAMD) were employed to evaluate the motor function,cogniton and depression,respectively.Results The prevalence of apathy and depression in the 77 PD patients were 49.4％ ( 38/77 ) and 46.8％ (36/77),respectively.Of the 77 PD patients,11 cases had apathy without depression (14.3％ ); 9 cases had depression without apathy( 11.7％ ) and 27 cases had apathy combined with depression( 35.1％ ).Among the PD patients with apathy,the cognitive type is the most common one,accounting for 86.8％ (33/38).There were significant statistical differences in education level,UPDRS- Ⅱ/Ⅲ scores,Hoehn-Yahr staging,MoCA and HAMD scores between apathy ( n =38 ) and no-apathy(n =39) PD patients(t =2.309,-3.144,-4.000,-3.217,2.649,-3.909,all P＜0.05).According to the unifactoral Logistic regression analysis of apathy correlates,UPDRS-Ⅱ/Ⅲ scores,HoehnYahr staging and HAMD scores were the risk factors for apathy while education level and MoCA were the protective factors for apathy.In the multiple Logistic regression analysis,HAMD scores,UPDRS-Ⅱ scores and education level were included.Conclusions The prevalence of apathy in PD patients was significantly higher than healthy controls.Apathy could be present without depression in PD patients,and was associated with education level,motor dysfunction degree,cognitive impairment and depression severity.

Parkinson's disease was primarily considered to be a movement disorder affecting only the extrapyramidal system. Although the non-motor symptoms such as neuropsychiatric symptoms, dysautonomia, sleep disturbances and olfactory dysfunction, etc., were also common, they were often misdiagnosed or neglected. This paper would review the manifestation, relevant factors, pathogenesis and treatment of non-motor symptoms of Parkinson's disease.

Objective To investigate clinical results of bilateral triceps bradhii approach in Gartland Ⅲ supracondylar fracture of humerus in children by comparing with reduction interne and plaster immobilization. Methods 102 children with Gartland Ⅲ supracondylar fracture of humerus,4 ～ 13 years old,from May 2003 to May 2009,were randomly divided into operation group and control group,51 cases separately. The operation group was treated by bilateral triceps bradhii approach, while control group was treated by reduction interne and plaster immobilization. All patients were made function exercise 4 weeks later,X-ray check periodically and followed up about 16 months with angle patronner and elbow joint function recorded. According to Flynn clinical function criteria,all patients were classified and analyzed. Results After follow-up and elbow joint function evaluation,48 cases ( 94. 1% ) show excellent and good results,3 cases(5.9% ) fair and poor in operation group,32 cases(62. 7% ) and 19 cases(37. 3% ) in control group. The differences between two groups was statistically singnificant ( P < 0. 05). Conclusion Comparing with reduction interne and plaster immobilization, bilateral triceps bradhii approach in Gartland Ⅲ supracondylar fracture of humerus in children has good clinical results and may be more effective therapy.

The medicine of critical disease is a clinical discipline that gradually sprang up in the late 1960s.Yet at present controversy still exists as to whether the discipline should be regarded as a separate one and it has not been ranked among the separate disciplines listed by the State Educational Committee. The authors, however, give an account of the customers and the cunent situation of disciplinary development of the discipline of critical disease from the petspective of a discipline. They also offer an account of the organizational structure and the form of staff of ICUs,pointing out that ICUs have 3 subjects structurally and are divided into CategoriesⅠ,Ⅱand Ⅲ. Except for ICUs in a few hospitals that are up to the level of Category Ⅱl, ICU s in most hospitals in China are lower than or just up to the level of Category Ⅰ. Then the authors give an introduction to the three forms of ICU management: open, semi-open and closed.

The medicine of critical disease is a clinical discipline that gradually sprang up in the late 1960s. Yet at present controversy still hats as to whether the discipline should be regarded as a separate one and it has not been ranked among the separate disciplines listed by the State Educational Committee. The authors, however, give an account of the customers and the current situation of disciplinary development of the discipline of critical disease ho the perspective of a discighne. They also offer an account of the organizational structure and the form of staff of ICUs, pointing out that ICUs have 3 subjects structurally and are divided into CategoriesⅠ,Ⅱ and Ⅲ. Except for ICUs in a few hospitals that are up to the level of Category n, ICUs in most hospitels in China are lower than or just up to the level of CategoryⅠ. ho the authorss give an introduction to the ho formsn of ICU management open, semi-opened-cpc ana closed.

Objective To inquire into the diagnosis and management of renal angiomyolipoma.Methods The 22 cases of RAML were studied restrospectively.Results The diagnosis accuracy was 54.5% for B ultrasound and 81.8% for CT,18 were diagnosed as RAML and 4 were misdiagnosed as renal cell carcinoma preoperatively,of which 3 were diagnosed as RAML based on intraoperative frozen section study.11 had been performed enuoleation,7 partial nephrectomy,3 nephrectomy and 1 radical nephrectomy. Conclusions CT is the first line imaging method for RAML.the cow fatty component,intratumor hemorrhage and small tumor are the main canse of misdiagnosis in RAML.careful analysis to clinical feature and imaging data,intraoperative frozen sect,ion study can avoid misdiagnosis.nephron sparing surgery is the best operative management.

Objective To investigate the effects of anti-parkinsonian drugs on cytokines(IL-6 and TNF-?) produced by PBMC in PD patients. Methods 25 subjects were divided into 3 groups : normal controls(NC),pergolide and Madopar treated PD patients(P+M group),Madopar treated PD patients(M group). PBMC were cultured in the presence of pure RPMI-1640,RPMI-1640 with ConA and RPMI-1640 with pergolide,respectively. The amount of IL-6 and TNF-? in the culture media was measured by enzyme-linked immunosorbent assay (ELISA). Results IL-6 production amount by PBMC when stimulated with ConA was significantly lower in group P+M and M than in group NC( P 0.05). In group P+M,the concentration of TNF-? was significantly higher in the presence of ConA than in the presence of pure RPMI-1640 and in the presence of pergolide( P 0.05). Conclusions The ability of amount by PBMC of PD elderly patients to excrete IL-6 was significantly decreased in the presence of ConA. Pergolide might arise the excretion of IL-6 by PBMC during the treatment process of PD and at the same time does not arise the excretion of TNF-?,which might be neurotoxic.

Objective To investigate the relationship between the infarction area and the changes of serum fibrotic indexes in acute myocardial infarction (AMI) patients.Medthods Serum procollagen type Ⅲ (PCⅢ),collagen IV(IV?C) and laminin (LN) were measured in 42 AMI patients with successful recanalization,22 AMI patients with unsuccessful recanalization and 37 healthy controls.Michelle's method was used to calculate infarction area and correlative analysis was made between indexes and infarction area.Results Serum PCⅢ,IV.C and LN were significantly increased in AMI patients with unsuccessful recanalization as compared with the other two groups,which were positively correlated with the infarction area.However,there was no statistical significance between the indexes in the other two groups and infarction area.Conclusion Serum PCⅢ,IV.C and LN can be serum fibrotic indexes in AMI patients,which can reflect the infarction area indirectly.

Objective To study the working memory changes in patients with Parkinson disease(PD).Methods The Smith working memory software was used and 66 cases of PD patients and 60 normal controls were enrolled.Results The results showed that the correct rate of visuo-spatial working memory was significantly decreased (P0.05) working memory impairment found in PD patients. The correct rate of visuo-spatial and visuo-object working memory in the middle stage of PD was significantly decreased than that in the early stage. The relative analysis showed that the Hoehn-Yahr stage, a negative relationship to the correct rate of visuo-spatial and visuo-object working memory.Conclusion Spatial working memory impairment without object shape and the color working memory impairment were found in the early stage of PD. As disease advanced both the visuo-spatial and object shape working memory deficits were found exacerbated.