Objective To study clinical characteristics and CT features of cerebellar hemorrhage in the elderly patients in order to make early diagnosis and treatment. Methods The clinical characteristics, CT scan, sites and causes of hemorrhage, as well as the treatment and the prognosis of 32 elderly patients with cerebellar hemorrhage were analysed. Results The main clinical symptoms were vomiting, vertigo and headache and were observed in 32(100.0%), 26(81.2%) and 18(56.2%) cases, respectively. High motality rate was observed in hemorrhage volume≥25 ml, patients aged over 70 years and accomanied with cerebral hernia and multi-organ failure. Conclusions The clinical manifestations of cerebellar hemorrhage were not typical in the elderly. Cerebral hernia and multiple organ failure were the main causes of death. Hypertension and artherosclerosis were the main etiologies of cerebellar hemorrhage. The early diagnosis is necessary for the treatment of cerebellar hemorrhage. The prognosis was related to the quantity and site of hemorrhage.

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 effect of lovastatin on hyperlipemia of children with nephrotic syndrom.Methods 43 cases of nephrotic syndrome were randomly divided into treatment group (n=21) and control group (n=22), all of which were given prednisone.Lovastatin was added to the treatment group.Before treatment and one month after treatment liver function and serum lipide were measured.Results The levels of serum apolipoprotein B (ApoB),total cholesterol (TC), trigtycerides (TG), low density lipoprotein cholesterol (LDL C) and lipoprotein (a) (Lpa) were obviously decreased compared with that before treament (P

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.

Objective To explore the characteristics of prospective memory impairments in patients with Parkinson's disease (PD) at the early and middle stage. Methods Fifteen PD patients at the early and middle stage and 15 normal controls matched with age, sex, education and occupation were asked to complete event-based prospective memory (EBPM) and time-based prospective memory (TBPM) tasks. Results In the EBPM task (points), there was a significant difference between PD patients (3.93±2.69) and normal controls (6.00±2.17, t =-2.318,P <0.05). In the TBPM task(points), there was no significant difference between PD patients (3.47±1.96) and normal controls (3.80±1.70, t= -0.498, P >0.05). Conclusion The EBPM is impaired and the TBPM is relatively spared in early and middle stage PD patients.

Objective To study the relationships between clinical and endoscopic findings of children with Henoch-Schoenlein purpura ( HSP). Methods All of the 51 cases with HSP from Aug 2000 to Apr 2004 were checked up by endoscopy, either gastroscopy and/or colonoscopy, and analyzed the relationship between clinical and endoscopic fingings. Results Fifteen out of 51 cases had no prominent changes in endoscopies, and 36 cases had different lesions in gastric, duodenal or colonic mucosa. There were 4 cases presented with simple lesion on stomach mucosa and 7 cases on colonic mucosa; and 25 cases had the lesions presented in gastrie, duodenal and/or colonic mucosa. The main findings in mucosa were exudates, erosion and hemorrhage. Conclusion There are obvious lesions in stomach, duodenum and /or colonic mucosa of HSP in children. Sometimes, these lesions happened before the appearance of skin purpura. There are close relationships between the lesions and the clinical manifestations of HSP in children, and therefore the endoscopic check up of HSP in children has very important significance in early diagnosis.

Objective To investigate the etiology and treatment of iatrogenic ureteral injury(IUI) and bladder injury(IBI). Methods Forty-seven patients(7 males, 40 females) with ureteral and bladder inju-ries caused as a result of any medical procedures were reviewed from 1996 to 2007. Obstetrics and gynecolog-ical, urological,general surgical procedures were involved in 38, 6, and 4 of the injuries respectively. Re-sults Sixteen cases of IUI were found during operation, including 14 cases of entire ureteral laceration, 4 cases of partial ureteral laceration. Thirteen cases received ureteral anastomosis, one case received uretero-neopyelostomy. One case of ureteral perforations during ureteroscopic procedure was indweUed of double-J after the operation was terminated immediately. Three cases received nephrectomy. Four cases of lower ure-teric suture ligation and three cases of ureterovaginal fistula were detected at 3 days～ one week of postopera-tion. These 7 cases were received ureteroneocystomy during 2 weeks after the initial surgical procedure. Nineteen cases of IBI were found during operation, the length of cystic wound was ranging from 1 cm to 3 cm. 17 cases underwent repairing, 2 eases of bladder perforation which caused by endourologic or TVT procedure received catheterization for 1 week. Five cases of vesicovaginal fistula which were found during one week--one month of post-operation, were received fistula resection and bladder repairing 3 months after of initial operation. Forty-seven cases were follow-up ranging from 5 months to 11 years after the second opera-tion,mean time were 47 months. All cases were recovered. Conclusions Intraoperative findings and effec-tive treatments can achieve good therapeutic effects and avoid injury during secondary operation. Correct treatment of urinary fistula can promote cure rate.

Objective To study the therapeutic efficacy of dopaminergic agonists,? dihydroergocriptin(Cripar) by multiple center opened trial Methods Sixty cases of Parkinson's disease were divided into two groups: monotherapy group(27 cases) and combined therapy group(33 cases) The improvement in both groups after therapy was observed Results Patients undergone monotherapy were treated with ? dihydroergocriptin and those undergone combined therapy were treated with combined use of ? dihydroergocriptin and L doparmine All patients after treatment showed improvement of clinical symptoms There were 7 patients (28 0%) in the monotherapy group and 13 patients (39 4%) in the combined therapy group markedly improved Evaluation of therapeutic improvement by modified UPDRS revealed that the average scores was 5 01 in monotherapy group and was 6 39( P

Objective To determine if examination of mirror writing in the elderly could be used to assess the degradation of the brain function.Methods The occurrence of mirror writing in 146 subjects was examined. Among them, 104 were males and 42 females. All subjects were university graduates. Age ranged from 40 to 85 years with an average of 62.7±13.4. These subjects were divided into two groups, a non-elderly group consisting of 60 subjects (41.1%) and an elderly group 86 subjects (58.9%). All 146 subjects were examined with 10 items for determination of handedness, mini-mental state examination and the written language of Chinese Aphasia Examination Scale (Draft) including spontaneous writing, writing from dictation and copying. The above mentioned performances of written language were done by left and right hand.Results The results of examination revealed that in 146 subjects there were 7 subjects with mirror writing, which occurred only in the elderly group, accounting for 8.1%. In the elderly group, mirror writing was found in one subject of 70-79 years group and 6 subjects of age over 80 years. Mirror writing appeared in the elderly was of mild degree with an average percentage of 1.9±0.4.Conclusion It is suggested that examination of mirror writing in the elderly may be used to assess the degradation of the brain function in senile subjects.

OBJECTIVETo improve the therapeutic and preventive measure for elderly patients (75 years and over) with idiopathic Parkinson's disease (OEIPD).

METHODSFifteen OEIPD patients were observed prospectively over a long period of time. Their diagnosis was confirmed by autopsy. Based on clinical and pathological data, the causes of death were analyzed.

RESULTSThe mean clinical course in OEIPD patients was 6.2 +/- 3.6 years. The majority of the 15 patients were the akinetic type and the akinetic type with tremor (80.0%). In the late stages of disease (4.8 +/- 3.5 year), choking occurred in 12 OEIPD patients who received nasal feeding for an average of 4 months after the occurrence of choking. The most common complication in 12 patients was repeated pulmonary infections with an average rate of 2.9 +/- 1.9. The causes of death were bronchial pneumonia and shock induced by pulmonary infection (11 cases, accounted for 73.3%), acute myocardial infarction (2 cases), one case with cardiac rupture and one case with rupture of aortic aneurysm.

CONCLUSIONSThe clinical course was shorter in OEIPD patients. Levodopa therapy should be started early in OEIPD patients. Bronchial pneumonia and infectious shock constitute the major cause of death and choking was one of the main causes of aspiration pneumonia. Nasal feeding should be started as early as possible after the appearance of choking. Silent aspiration can be reduced by teaching the patient to protect the airway by 'supraglottic swallowing'.

Aged ; Aged, 80 and over ; Airway Obstruction ; etiology ; Brain ; pathology ; Cause of Death ; Enteral Nutrition ; Female ; Humans ; Lung ; pathology ; Male ; Parkinson Disease ; complications ; mortality ; pathology