OBJECTIVE:To optimize the formula of pilocarpine nitrate eye drops by orthogonal test and decision design and to predict the stability of the preparation METHODS:The L9(33)orthogonal test method was used The test was performed according to the storage time and temperature,each of which took three levels to assess the stability and to choose the optimum formula to do the temperature accelerating test and estimate the stability by t0 9 methods RESULTS:The optimum point was pH4,temperature 8℃ and storage time 12 hours The storage period estimated by temperature accelerating test was 76 9 days CONCLUSION:It is simple,quick and accurate to predetermine the stability of pilocarpine nitrate eye drops by methods of orthogonal test and decision design

Objective To assess the effect of swallowing function training on dysphagia.Methods66 patientswith dysphagia were randomly divided into training group and control group. The swallowing function of the two groupswere evaluated before and after training.ResultsThe effective rate of training group is 78.1% which is higherthan control group (P< 0.01).ConclusionSwallowing function training can significantly improve swallowing function and activity of daily living of the patients with dysphagia.

Objective To characterize the secondary osteoporosis in hemiplegic patients. Methods By use of dual energy X ray absorptometry, the bone density and bone mineral quantity of 156 hemiplegic inpatients were tested and analyzed. Results The incidence of osteoporosis was 44.4% during 3～6 months after stroke and 21.1% found during 9～12 months after stroke. The average incidence was 30.8%. The osteoporosis was more common in patients with flaccid hemiplegia than in those with spastic hemiplegia. The bone mineral quantity in the affected upper limbs was significantly lower than that in nonaffected side ( P 0.05). Conclusion The bone mineral quantity of hemiplegic patients varies with the duration of disease. The reduction of bone mineral quantity is regular and reversible.

BACKGROUND: Hemiplegia caused by stroke or brain injury may lead to secondary osteoporosis. Under the circumstance, bone mineral density (BMD) and Bone Mineral Content (BMC) are two effective factors for predicting the risk of osteoporosis-related fracture OBJECTIVE: To investigate the characteristics of secondary osteoporosis in stroke patients with hemiplegia by measuring and analyzing BMD and BMC.DESIGN: A case study.PARTICIPANTS: From March 1999 to May 2002, 156 hemiplegia patients at the Neurorehabilitation Department of Peking Boai Hospital were selected, 87 males and 69 females, with an age ranging from 17 to 65 years old, in average of (47.0±5.3) years old and having a course of diseases ranging (5.0±3.5) months. The types of their illness: 89 had cerebral infarction, 67 had cerebral hemorrhage. Hemiplegia sides: 79 patients had hemiplegia in the left and 77 in the right.METHODS: Using LUNAR Dual Energy X-Ray densitometers, all the patients underwent a fro-top-to-toe scan to assess the BMD and BMC status.MAIN OUTCOME MEASURES: ① The occurrence rate of osteoporosis in patients with various course of hemiplegia. ② The BMC in patients with hemiplegia in various part.RESULTS: All the 156 patients entered the statistical analysis procedure.① The occurrence rate of osteoporosis was highest in patients with 3 to 6 months of hemiplegia (44%, 16/36) and was lowest in those with 9 to 12 months of disease (21%,7/33). The total occurrence rate of osteoporosis was 31% (48/156). ② For those with a less-than-3-month course of hemiplegia: Of all the 47 patients, 9 had dystonic hemiplegia, all suffering from osteoporosis and 2 of whom having fracture. For those with a 3-to-6-month course of hemiplegia: Of all the 36 patients, 3 had dystonic hemiplegia and osteporosis as well. ③ BMC in the affect side of upper limb was signifi cantly lower than that in healthy side [(154.76±43.91) g, (172.59±43.78) g,t=3.591, P＜ 0.001]. BMC in the affect side of lower extremity was close to that in healthy side [(463.41±30928) g, (464.11±86.45) g, t=0.027, P＞ 0.05].CONCLUSION: In patients with hemiplegia, changes in bone mass fluctuate with the length of hemiplegia. BMC in the affect side of upper limb is low while that in the healthy side is nearly normal. It may be explained that upper extremities start the functional exercises at an early time. This indicated that bone mass has a close relationship with excercises.

Respiratory dysfunction is a significant part of disorders associated with stroke. Stroke could impair respiratory center or motor pathway, leading to alter breath pattern or reduced respiratory muscle strength. Pneumonia secondary to stroke and stroke-associated sleep apnea are common respiratory disorder, which are adverse to the prognosis of stroke. Clinical routine physical examination is basic evaluation of respiratory function. Attention should be paid especially in breath pattern, respiratory muscle volume and muscle tone. Multiple quantitative assessments include arterial blood gas analysis, sleep apnea monitoring, dynamical, imaging and electrophysiological tests. Rehabilitation can be used to improve the inspiratory muscle strength, endurance and cough effectiveness, reduce sleep apnea hypoventilation, enhance the cardiorespiratory fitness, finally improve the quality of life in stroke patients.

Objective To explore the effect of low frequency repetitive transranial magnetic stimulation (rTMS) on unilateral spatial neglect (USN). Methods 40 stroke patients with USN were divided into treatment group (n=20) and control group (n=20). Patients in the treatment group were treated with low frequency rTMS for 2 weeks. The USN degree of these groups were evaluated before and after the treatment. Results There was no significant difference of USN degree between these groups before the treatment (P>0.05); Compared with the control group, the treatment group improved significantly after the treatment (P<0.05). The USN degree of patients in the treatment group decreased significantly after the treatment (P<0.05), while patients in the controlled group had no difference (P>0.05). Conclusion USN induced by stroke could be improved obviously through low frequency rTMS.

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Objective To investigate the effectiveness and safety of oral olive oil combined with polyethylene glycol electrolyte ( PEG ) on bowel preparation before colonoscopy for chronic constipation patients. Methods A randomized, single-blind, prospective study was conducted on 180 patients with chronic constipation, who underwent colonoscopy at Tangdu Hospital of the Fourth Military Medical University from November 2017 to May 2018. Patients were randomly divided into three groups. Patients in group A took 60 mL olive oil and a piece of crystal sugar at 7:30 pm the day before colonoscopy, followed by 1500 mL PEG at 8:00 pm before the test, and 1500 mL PEG at 5:00 am the day of colonoscopy. Patients in group B took 60 mL olive oil and a piece of crystal sugar after administration of PEG at 8:00 pm the day before colonoscopy, followed by 1500 mL PEG at 5:00 am the day of colonoscopy. The group C was given 1500 mL PEG at 8:00 pm the day before colonoscopy, and another 1500 mL PEG at 5:00 am the day of colonoscopy. We recorded the time of first defecation after taking medication, the number of defecation before sleep, the total number of defecation, the score of Boston bowel preparation scale ( BBPS) of the right, middle and left colon, and the adverse reactions, and compared the data among the three groups. The measurement data was compared using the analysis of variance. After the difference was found, the LSD-t test was used to compare between the two groups. The enumeration data was compared using the Pearsonχ2 test. Results One patient in the group B terminated colonoscopy due to unable to continue cooperation during the examination. Group B and C both excluded one patient because of a large mass found in the descending colon of patients. Finally, there were 60 cases in the group A, 58 in the group B, and 59 in the group C. There was no statistical difference between the three groups in the general resource ( P>0. 05) . The time of first defecation after taking medication for the group A, B and C was (2. 25±2. 32) h, (2. 43±2. 39) h and (3. 36±2. 79) h respectively, with statistical difference (F=3. 36, P=0. 037). The time of first defecation was longer in the group C than that of the group A and B ( P = 0. 016 and P = 0. 046, respectively). The number of defecation before sleep for the group A, B and C was 3. 47±2. 09, 3. 24±1. 76 and 2. 49±1. 58 respectively, with statistical difference (F=4. 65, P=0. 011). The number of defecation before sleep was lesser in the group C than that of the group A and B ( P=0. 004, P=0. 027, respectively) . The total number of defecation for the group A, B and C was 7. 20 ± 2. 67, 6. 81 ± 2. 31 and 5. 64 ± 2. 22 respectively. The difference among the three groups was statistically significant ( F=6. 68, P=0. 002) . For the group A and B, the total number of defecation was both more than that of the group C ( P=0. 001, P=0. 010) . There were no statistical differences among the three groups in the BBPS score of the left and middle colon and the total BBPS score ( all P>0. 05) . The BBPS score of the right colon for the group A, B and C was 2. 03 ± 0. 82, 1. 95 ± 0. 87 and 1. 53 ± 0. 80 respectively, with statistical difference ( F=6. 38, P=0. 002) , and was lower in the group C than that of the group A and B ( P= 0. 001, P= 0. 006, respectively) . Adverse reactions after taking medication including nausea, vomiting, abdominal pain, and bloating were respectively reported in 7, 3, 0 and 3 cases in the group A, 5, 3, 0 and 6 in the group B, and 4, 2, 1 and 4 in the group C, and there was no statistical difference among the three groups (χ2=4. 35, P=0. 824) . Conclusion Administration of olive oil compared with PEG can improve the cleanness of right colon for chronic constipation patients, shorten the time of first defecation after taking medication, and increase the number of defecation before sleep and the total number of defecation during bowel preparation. Taking olive oil before or after PEG at the night before colonoscopy has no significantly effect on bowel preparation and adverse reactions.

Objective Construct a scientific and reasonable evaluation index system for clinical specialties of tradi-tional Chinese medicine in Shandong Province to provide a scientific basis for improving the service capacity of clini-cal specia lties of traditional Chinese medicine.Methods Based on relevant policies and literature research,the analytic hierarchy process and Delphi expert consultation method were used to determine the index system and its weight,and 509 clinical specialties of traditional Chinese medicine capacity levels of 178 medical institutions in Shandong Province were evaluated.Results A scientific and effective evaluation index system for clinical specialty capacity of traditional Chinese medicine in Shandong Province was constructed,with 23 secondary indicators in 5 dimen-sions.It comprehensively evaluats the service capacity and management level of orthopedics and traumatology de-partments of traditional Chinese medicine class hospitals in Shandong Province,uses orthopedics and traumatology as an example.Conclusion Driven by the dynamic monitoring of the evaluation index system,improve the service ca-pacity for clinical specialties of traditional Chinese medicine,guide it to strengthen the internal construction of tradi-tional Chinese medicine,and give full play to the advantages of traditional Chinese medicine characteristics.Increase the support for clinical specialties of traditional Chinese medicine in Shandong Province,and then promote the high-quality development of traditional Chinese medicine.

Objective:To investigate the clinical, neuropsychological, and neuroimage characteristics in patients with corticobasal syndrome (CBS), and to elucidate the exact diagnosis of CBS patients.Methods:Twelve CBS cases admitted to the Department of Neurology, Huashan Hosiptal,Fudan University from April 2019 to July 2021 were retrospectively enrolled in this study. Those data, including clinical features (demographic data and clinical characteristics of cortical dysfunction and movement disorder), neuropsychological assessment [Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scales score], brain magnetic resonance imaging (MRI) and multi-mode positron emission tomography (PET)/CT, were collected and carefully reviewed. Exact diagnosis of these patients was given according to the disease diagnosis criteria.Results:Cortical dysfunction and asymmetrical movement disorders were found in all cases, with poor response to levodopa. Patients suffered from cognitive impairment (MMSE score 16.16±9.82, MoCA score 13.44±7.35). The cranial MRI demonstrated significant asymmetric atrophy of frontal and parietal lobes, especially in the pre- and post-central gyrus. Fluorodeoxyglucose PET of 12 patients showed asymmetric frontal lobe and basal ganglia (especially caudate and putamen) hypometabolism (obviously on the contralateral side of the affected limb). Tau PET was implemented in 11 patients and displayed that abnormal tau protein deposition was positive in the cortex and/or subcortex in all patients. Of the 4 cases, who completed amyloid PET, amyloid protein deposition was positive in the cortex of 2 patients. As a result, 6 patients were diagnosed as progressive supranuclear palsy, 1 patient was diagnosed as corticobasal degeneration, and 5 patients were diagnosed as Alzheimer′s disease.Conclusions:The etiology of CBS is heterogeneous. The combination of clinical manifestation, cranial MRI and multi-mode PET/CT helps the differential diagnosis of CBS.