Objective To evaluate whether the prognosis of 6 months major adverse cardiac events(MACE)after acute myocardial infarction,and the reperfusion state of myocardial tissue are related to the white blood cell(WBC)count in elderly patients.Methods A total of 101 consecutive patients aged≥60 years(mean age 70?6 years)who had a primary percutaneous coronary intervention as their first-line therapy for ST-elevation myocardial infarction(STEMI)were enrolled, and both their WBC count on admission and ST-monitoring were available.A prospectively defined cut-off value of WBC count was 10,000/?l,a cut-off 50% measured after 60 min was used as ST -segment resolution(STR).Results The high WBC count group(n=48)showed the significantly higher(52.1% vs 22.6%,P＜0.01)incidence of 6 months major adverse cardiac events(MACE)than did the,low WBC count group(n=53).The low WBC count group had 45 patients with STR≥50%, high WBC count group had 23 patients with STR≥50%,STR after PCI was significantly different between the 2 groups(P＜0.01).Conclusions The WBC count is a predictor of the adverse outcome in elderly patients with STEMI.Furthermore,elevation in WBC count is associated with poor myocardial microcirculatory reperfusion.

Objective To discuss the clinical features and related factors of psychosis in patients with Parkinson's disease (PD) and assess the prevalence of psychosis.Methods A total of 82 patients with Parkinson's disease and 69 healthy controls were evaluated by Brief Psychiatric Rating Scale and neuropsychiatric questionnaire.For the PD group,the age at PD onset,type and dose of PD medications,and rapid eye movement (REM) sleep behavior disorder (RBD) were recorded.Unified Parkinson's disease rating scale (UPDRS,parts Ⅱ and Ⅲ) and Hoehn-Yahr staging were used for the evaluation of the severity of motor dysfunction,Hamilton depression scale (HAMD) for emotional state,montreal cognitive assessment (MoCA) for cognition,and scales for outcomes in Parkinson's disease-SLEEP (SCOPA-SLEEP) for quality of sleep.Results The prevalence of psychosis was 36.59％ in PD patients and 2.90％ in the control group.The difference between the two groups was statistically significant (P＜ 0.001).Among the 30 PD patients with PD psychosis meeting the NINDS/NIMH criteria,patients experienced illusions,false sense of presence,hallucinations and delusions was 22.0％,14.6％,29.3％,and 7.3％,respectively.Univariate analysis showed that age,levodopa equivalent dosage,SCOPA-SLEEP scores,and prevalence of RBD were significantly higher in thePDP group [(71.1±6.18),(628.7±283.2),(15.3±7.28),60.00％] than in the PDNP group [(66.6±9.25),(461.1±317.2),(9.7±7.64),28.85％] (all P＜0.05).Multivariate analysis showed that Hoehn-Yahr staging was a protective factor (OR =0.039,95％ CI:0.004-0.402),while sleep disorder was a risk factor (OR=1.157,95％CI:1.015-1.320).The PD patients with more psychotic symptoms were much older and with higher SCOPA-SLEEP scores,which had a statistically significant difference (P =0.0042,P =0.0112).Conclusions The prevalence of psychosis is much higher in PD patients than in healthy controls.PD psychosis is correlated with older age,larger levodopa equivalent doses,higher SCOPA-SLEEP scores,and prevalence of REM sleep behavior disorder.

Objective To observe the injury to the heart,liver and kidney induced by hind limb ischemia/reperfusion(I/R),and to study the protective effect of H2S by attenuating this injury,in order to offer a theoretical basis for therapeutic application.Methods A model of hind limb I/R was reproduced.28 rats were divided randomly into 4 groups:normal control group(C,n=8),ischemia 4h group(I,n=8),ischemia 4h and reperfusion 4h group(I/R,n=6)and I/R+NaHS group(n=6)(NaHS can provide H2S for rats in vivo).The concentrations of CK,CK-MB,Tn-T,ALT,AST,Cr and urea in blood plasma were determined.The pathological changes in the heart,liver and kidney were observed with HE staining.Results The concentration of CK,CK-MB and Tn-T in I group increased significantly compared with that in C group,and that in I/R group was higher than in I group.No significant difference was found in plasma concentration of ALT,AST,Cr and Ur between C group and I group,while it they were increased significantly in I/R group compared with that in I group,and that in I/R+NaHS group were decreased significantly compared with that in I/R group.Pathological examination revealed pathological findings of injury to the heart,liver and kidney in I group,and even more serious injuries were found in I/R group than in I group,while the they were less marked in IR+NaHS group compared with that in I/R group.Conclusion Hind limb ischemia/reperfusion may result in injury to the heart,liver and kidney.H2S may attenuate injury to remote organs follawing hind limb ischemia/reperfusion.

Objective To observe the effect of rapid reduction of physical activity on bone mass (BMC), bone mineral density (BMD)and bone metabolism in growing rats. Methods 48 male SD rats were divided into the high-intensity exercise group (T1, n=12), high tolow-intensity exercise group (T2, n=12), low-intensity exercise group (T3, n=12) and control group (Con, n=12). During the first 6 weeks,the rats in T1 and T2 group ran on treadmill with high intensity, while rats in T3 group took low-intensity treadmill exercise. 6 rats were sacrificedfrom each group at the end of 6th week. BMC, BMD of femur were measured with DEXA. Alkaline phosphatase (ALP), osteocalcin(BGP), tartrate-resistant acid phosphatase (TRACP) were detected with ELISA. The exercise intensity of T2 group was reduced rapidly to alow level as in T3 group, but remained in the other 2 groups. At the end of the second 6 weeks, the other rats were investigated again. ResultsCompared with the first measurements, ALP and BGP of the T2 group decreased significantly (P<0.05), and TRACP increased (P<0.05). There was no significant difference in BMC and BMD of femur (P>0.05). Conclusion Rapid reduction of physical activity can suppressbone formation and stimulate bone resorption of long bone among growing rats.

Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; Thrombocytopenia ; etiology ; therapy

Chronic Disease ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Liver Diseases ; drug therapy

Objective To study the MRI findings of HE and the pathological mechanism and to improve the diagnosis and differential diagnosis of HE. Methods Five patients of HE diagnosed by clinical and laboratory examination were examined with conventional MRI scan. Additional DWI, MRA and enhancement MRI scan were performed on 3 patients in which abnormal findings was detected on the conventional MRI. The distribution of lesions and signal characteristics were analyzed. The ADC values of the lesions and of the contralateral non-lesion area were measured. Moreover, the possible pathological mechanisms of HE were discussed on the basis of changes of clinical and imaging manifestations in the two cases with serial clinical and MRI data. Results Of 5 patients, brain abnormalities were found in 3 cases,which showed scattered spotted supratentorial white matter lesions of isointensity on T1 WI and DWI, and high signal intensity on T2WI and fluid-attenuated inversion recovery (FLAIR). Meanwhile, multiple plaque-like lesions involving both white matter and gray matter were found, mainly located at the basal ganglia nuclei, hippocampus and cingulate cortex. The lesions demonstrated iso-or hypo-intensity on T1 WI,and iso-or hyper-intensity on T2 WI, FIAIR and DWI at the initial stage. No enhancement was found in these lesions and MRA disclosed no remarkable findings. The ADC value of the lesions [ (0. 449 ± 0. 092) ×10-3 mm2/s] was decreased significantly compared with the contralateral noninvolved area [ (0. 838 ±0. 062) × 10-3 mm2/s] at the early onset. In 2 cases with glucocorticoid therapy, together with symptom relief, MRI follow-up scan demonstrated the reduction of lesion volume, the signal change to hyperintensity on T1 WI and hypo-intensity on DWL The ADC of the lesions increased significantly. Conclusion The MRI could be one of the effective tools for diagnosis, differential diagnosis, and judging the prognosis and therapeutic results of HE. Meanwhile, it may be a non-invasive method to study the pathological mechanism of HE.

Objective To investigate the effects of different doses of dexmedetomidine used in SEP and MEP monitoring in patients undergoing neurosurgery. Methods Eighty patients undergoing neurosurgery receiving SEP and MEP monitoring were randomly divided into 4 groups(n = 20 each):group C,group D1,group D2 and group D3. In groups D1 ,D2 and D3 ,dexmedetomidine 0.5 μg/kg was infused over 10 minutes before anesthesia induction,and then was infused at a rate of 0.1,0.3 and 0.5μg/(kg·h)respectively toward the end of operation. Group C received the equal volume of normal saline. HR ,MAP and BIS were recorded at admission to the operating room(T1),skin incision(T2),when the muscle relaxants were stopped(T3)and 50 minutes later(T4). The current intensity and the time when first MEP was induced after muscle relaxant was stopped ,the amplitudes and latencies of SEP(N20-P25,N20)and MEP on thenar muscle at T4,the total consumption of propofol,and development of adverse affects were also recorded. Results Compared with groups C and D1,HR and MAP were decreased at T2-T4 in groups D2 and D3(P<0.05). The amount of propofol consumed were lower in groups D2 and D3 than in groups C and D1(P < 0.05). The current intensity inducing MEP was lower and the amplitude of MEP at T4 was higher in group D2 than in groups C,D1 and D3,and the situation was same in group D3 than in group C (P<0.05). No significant change was found in the other parameters in groups C ,D1 ,D2 and D3(P>0.05). Conclusion Dexmedetomidine infused at 0.3 μg/(kg · h) after infusion of a loading dose of 0.5 μg/kg could improve monitoring quality of MEP through reducing the amount of propofol consumed ,have less inhibition on MEP than other groups,have no obvious effects on SEP,andmaintain hemodynamic stability.

Objective To investigate the correlation between the reason of heterotopic ossification after cervical artificial disc replacement and the degeneration of cervical facet joints.Methods From May 2009 to May 2012,133 patients who had undergone cervical artificial disc replacement were included into this study.There were 74 males and 59 females with an average age of 42.63±4.15 years old (range,23-56 years old).There were 109 patients who had undergone single level implant,and 24patients double level implant.Cervical spine A-P and the flexion-extension X-rays were taken to assess the range of motion (ROM)of the surgical level.Degeneration degree of patients' cervical facet joints were evaluated by Park grading standards with the preoperative cervical CT scan images on GE-PACS system.Heterotopic ossification (HO) situation were evaluated by McAfee classification through cervical lateral X-ray film.Patients were divided into two groups (HO group and non-HO group) according to whether heterotopic ossification appeared during the follow-up period.The data were collected before surgery to the latest follow-up.Results The average follow-up time was 2.9 years (range,2.0-4.8 years).HO was detected in 25 patients (18.80％,25/133) at latest follow-up.The ROM of surgical level of patients in HO group was significantly lower than non-HO group (6.8°±3.9° vs 9.1 °±2.4°).In addition,the degeneration degree of cervical facet joints of patients in HO group was significantly higher than that in non-HO group.There was a significant correlation between preoperative cervical facet joint degeneration and the occurrence of HO after CDR (r=0.683,P=0.033).Conclusion There was a significant correlation between preoperative cervical facet joint degeneration and the occurrence of HO after CDR.Patients present HO after surgery have significantly higher degeneration degree of cervical facet joints than patients without HO.Patients with higher degree of HO may have a higher level of cervical facet joints degeneration.

Objective: To establish the methods for extraction and isolation of punicalagin from pomegranate peel, and further study the purification and quantification of punicalagin. Methods: Using an ultrasonic-assisted extraction method, punicalagin in pomegranate peel was extracted at room temperature by 50% ethanol with 20-fold volume of raw material. The content of punicalagin in the crude extract was determined by HPLC. To optimize the purification process of punicalagin, static adsorption and desorption experi-ments were employed to study five kinds of macroporous adsorbent resins (D101, A8-8, NKA-9, HPD-100 and HPD-500) for the one with the highest purification efficacy of punicalagin. In addition, the technical parameters of the macroporous adsorbent resin were opti-mized to obtain punicalagin with higher purity. Punicalagin was further separated and purified by using a reverse phase MCI GEL CHP20P column. Results:HPD500 resin showed the best ability to absorb and separate punicalagin in among five kinds of macro-porous adsorbent resins. The best technical parameters were as follows:the mass concentration of sample solution was 15 mg·ml-1 , the loading amount was 2BV, the pH was 2 and the eluting solvent was 8BV of 30% ethanol. With the best process as described a-bove, the content of punicalagin extracted from pomegranate peel increased from 10. 3% to 30. 7%. The obtained punicalagin could be further purified to 61. 3% from 30% in ethanol eluate by the reverse phase MCI GEL CHP20P column. Conclusion:HPD500 resin is the most effective in the purification of punicalagin from pomegranate peel, and the content of punicalagin can be dramatically increased after the purification by a reverse phase MCI GEL CHP20P column. The optimized process shows good reproducibility and stability.