Objective To investigate the efficacy and influence of motor function and activities of daily living of hexose ganglioside sialic four single(GM1)combined with rehabilitation in treatment of cerebral infarction(ACI). Methods 110 patients with ACI were divided into the two groups in random number table,they were all treated with routine treatment,the patients of the control group(n =55)were given citicoline on the base of those addition,the patients of the observation group(n =55)were given hexose ganglioside sialic four single combined with rehabilitation. The efficacy and influence of motor function and activities of daily living of the two groups were observed and compared.Results The total efficiency of the observation group was 90.91%,which was significantly higher than 76.36% of the control group(χ2 =10.33,P <0.05);The bathel index and the FMA points after treatment of the two groups were significant increased compared with before treatment,the difference was statistically significant(t =7.11, 9.83,8.66,10.27,all P <0.05);The bathel index and the FMA points after treatment of the observation group were (60.79 ±5.64)and(64.34 ±7.83),which were significantly higher than the control group(t =8.89,9.45,all P <0.05).Conclusion Hexose ganglioside sialic four single combined with rehabilitation in treatment of cerebral infarc-tion had significant clinical effect,it can effectively improve motor dysfunction,improve their daily living skills,with a high clinical value and was worth to appliy.

Objective To investigate the clinical efficacy of nicergoline combined with donepezil hydrochlo-ride in the treatment of mild vascular dementia and its influence on cognitive function.Methods 66 patients with mild vascular dementia from neurology were divided into two groups by random numbers,33 cases in each group.On the based of the routine symptomatic treatment,the control group were given nicergoline,the observation group were treated with nicergoline combined with aricept.Four weeks was a course,both groups were continuously treated for 3 courses.Results The MMSE scores of the observation group after treatment was (36.7 ±5.7)points,which was significantly increased compared with before treatment(t =10.137,P <0.05)and the control group(t =11.236,P <0.05);The ADL score was(35.8 ±16.2)points,which was significantly lower compared with before treatment(t =10.825,P <0.05)and the control group(t =11.415,P <0.05);The total effective rate of the observation group was 78.9%,which was higher than 54.5% of the control group(χ2 =9.24,P <0.05).Conclusion Nicergoline com-bined with donepezil hydrochloride in the treatment of mild vascular dementia can significantly improve cognitive func-tion scores,and it is a significant effect,safe and reliable method.

One-and-a-half syndrome with facial diplegia, also referred to as the fifteen-and-a-half syndrome, is an extremely rare clinical entity caused by involvement of bilateral tegmentum of pons. Herein, we report a 52-year-old male who presented with one-and-a-half syndrome with left facial paralysis, which was consistent with the so-called eight-and-a-half syndrome. Brain magnetic resonance imaging showed pontine infarction. Five days after initiation of antiplatelet therapy, the patient developed right facial paralysis, a diagnosis of fifteen-and-a-half syndrome was made, repeat MR imaging revealed bilateral pontine tegmentum infarction. Fifteen-and-a-half syndrome is a newly proposed concept associated with pontine infarction. The clinicoradiological features of this specific disease are as yet unclear due to its extreme rarity. The current case would help advance the current understanding of the disease spectrum of pontine infarction.

Objective To investigate the predictive value of combined analysis on single nucleotide polymorphisms (SNPs) of X-ray cross-complementing1 ( XRCC1 ) gene 194 and 399 codon,xeroderma pigmentosum group D (XPD) gene 312 codon and glutathione S-transferase P1 (GSTP1) gene 105 codon in platinum based chemotherapy.Methods Direct sequencing was performed to detect XRCC1,XPD and GSTP1 genotypes in peripheral blood from 50 cancer patients receiving platinum-based chemotherapy.Genetic polymorphisms of these genes related to sensitivity of platinum were reviewed.Results Favorable genotypes were Arg/Trp and Trp/Trp in XRCC1 194 codon,Arg/Arg in XRCC1 399 codon,Asn/Asn in XPD 312 codon and Val/Val in GSTP1 105 codon.The response rate to chemotherapy was 57.1％,75.0％,60.9％,85.7％ and 87.5％,respectively.The response rate for patients possessing ≥2 favorable genotypes and those possessing 1 or 0 favorable genotype was 78.9％,36.4％ and 0,respectively.Patients possessing ≥2 favorable genotypes demonstrated higher sensitivity to platinum based chemotherapy,compared with those possessing 1 or 0 favorable genotype ( x2 =25.79,P ＜ 0.01 ).Conclusions Combination analysis of genomic polymorphisms of XRCC1,XPD and GSTP1 may be useful in predicting sensitivity of platinum based chemotherapy.

0.05).Conclusion Both PTX plus DDP and NVB plus DDP are effective to advanced breast cancer.There are no significant difference between the two groups.The two regimens can be applied to the first line chemotherapy.

OBJECTIVETo confirm urinary incontinence after radical retro-pubic prostatectomy by questionnaire and pad-test, observe the influence of radical prostatectomy on the patient's quality of life (QOL), and study the effect of urethral sphincter preservation and the patient's age on incontinence.

METHODSQuestionnaire and pad-test were conducted in 165 consecutive prostate cancer patients who underwent radical prostatectomies. The mean follow-up time was 13 months (12-14 months). Each patient was kept in contact with our incontinence advisor by telephone or direct interview. At 12 months after operation, the patients were asked to the clinic to fill in the questionnaire and underwent the pad-test. In accordance to different operative techniques, the patients were divided into a sphincter repairing group (19 cases) and a sphincter preservation group (146 cases).

RESULTSAll the 165 patients were kept in contact with us, underwent the pad-test and filled in the questionnaire. Of the 7 patients diagnosed as incontinence for admitting using pads, only 1 had urinary leakage, and the other 6, who did not use pads very often, showed slight change of QOL. In the pad-test, 5 patients were considered to be incontinent since the pad weight gained > 1 grams. Between the questionnaire and the pad-test there was a high concordant rate (98.8%). Within 3 months after operation, younger patients seemed to return to continence sooner. The continence rate at 12 months after operation was 99.3% in the sphincter preservation group and 94.7% in the sphincter-repairing group. The incontinence rates at the removal of the urinary catheter after operation were 60% and 82% in patients aged 51-60 and 61-70, respectively. At 3 months after operation, the incontinence rates were similar in both groups.

CONCLUSIONBoth the questionnaire and the pad-test are recommendable in the assessment of post-operative incontinence since it can accurately document patients' incontinent status. Preservation of the urethral sphincter and its possible innervations can improve the incontinence rate. Younger patients seem to return to continence sooner than the elders.

Adult ; Age Factors ; Aged ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prostatectomy ; adverse effects ; Surveys and Questionnaires ; Urinary Incontinence ; diagnosis

OBJECTIVETo observe the effect of brachytherapy of 125I implantation on localized prostate cancer.

METHODSTwo-step technique was engaged in the implantation of 125I into the prostate for 41 localized prostate cancer patients. The prescription dosage of 125I was 160 Gy. TRUS and C-Arm X-ray were used for the confirmation of seeds location in the prostate.

RESULTSThirty-three patients were followed up for 3 to 4 years. Abnormal PSAs were found in 2 patients by positive biopsy. No patients died in this investigation. The early stage complications were urinary irritation symptoms that were severe within 6 months and disappeared after 1 year.

CONCLUSIONBrachytherapy of 125I implantation increases long-term tumor-free survival rate, with few long-term complications and some short-tern urinary stimulating symptoms.

Aged ; Aged, 80 and over ; Brachytherapy ; adverse effects ; methods ; Humans ; Iodine Radioisotopes ; therapeutic use ; Male ; Middle Aged ; Prostatic Neoplasms ; mortality ; radiotherapy ; Survival Rate

Objective Although aspirin resistance has been recognized to occur in patients with diabetes mellitus, the prevalence and related risk factors for aspirin resistance in elderly patients with diabetes mellitus have not been reported yet. The purpose of the present study was to evaluate the prevalence and potential risk factors for aspirin resistance in elderly patients with type 2 diabetes.Methods The 140 elderly patients [aged from 60 to 92 years, mean age (73.8±8. 0) years] with type 2 diabetes receiving daily aspirin therapy (≥ 75 mg) over one month were recruited. Platelet aggregation was measured by light transmittance aggregometry (LTA) and thrombelastograph (TEG)platelet mapping assay. Results By LTA, 6 patients (4.3%) of the diabetic patients were found to be resistant to aspirin therapy, 44 patients (31.4 %) were semi-responders. By TEG, 31 patients (22. 1%) were aspirin resistant. Among the 31 patients who were aspirin resistant by TEG, 3 were aspirin resistant by LTA. In the multivariate logistic regression analysis, female gender (OR= 5. 54,95%CI: 1.17-27.47, P=0.036) and homocysteine level (OR=1.15, 95%CI: 1.00-1.35, P=0. 043) were statistically significant risk factors for aspirin resistance by TEG. Conclusions The prevalence of aspirin resistance in elderly patients with type 2 diabetes is considerably higher in elderly female patients and in elderly patients with higher serum homocysteine level.

OBJECTIVETo assess the response of aging-related symptom complex to small-dose supplement of growth hormone.

METHODSThirty patients, aged 42 to 77, with aging-related symptom complex and normal serum testosterone were studied. Each subject received growth hormone at the dosage of 0.04 U/kg, 3 times/week for six months. Before and after treatment, body weight, grip strength, abdomen circumference, IPSS, uroflow rate, prostate volume, serum testosterone, cholesterol, triglyceride, PSA, IGF-1, glucose and side effects were determined in every case. Self Rating Scale used by Bosphorus university was adopted.

RESULTSAfter the treatment, the rating scores were significantly improved, grip strength and serum level of IGF-1 increased, and abdomen circumference and serum cholesterol decreased. Whereas, IPSS, uroflow rate, prostate volume, serum testosterone, triglyceride, PSA, glucose and body weight were not significantly changed.

CONCLUSIONSix months treatment with small-dose growth hormone can improve aging-related symptom complex with little adverse effect.

Adult ; Aged ; Aging, Premature ; drug therapy ; Andropause ; Blood Glucose ; metabolism ; Follow-Up Studies ; Growth Hormone ; administration & dosage ; Humans ; Insulin-Like Growth Factor I ; metabolism ; Lipids ; blood ; Male ; Middle Aged ; Prostate-Specific Antigen ; blood

Objective:To evaluate the effect of zoledronic acid administration for osteoporotic vertebral compression fracture (OVCF) after treatment with percutaneous kyphoplasty (PKP).Methods:A retrospective case-control study was performed on 430 elderly patients with OVCF admitted to the Second Affiliated Hospital of Soochow University from January 2012 to December 2016. There were 31 males and 399 females, with age of 52-92 years[(72.8±8.3)years]. Fracture segments were at T 5-T 10 (82 vertebrae), T 11-L 2 (389 vertebrae) and L 3-L 5 (173 vertebrae). In zoledronic acid group ( n=178), patients were given zoledronic acid 3 days after PKP surgery. In basic treatment group ( n=252), patients were only given basic treatment after PKP surgery. Bone mineral density was measured before operation and one year after operation. Visual analogue scale (VAS) and Oswestry disability index (ODI) were assessed before operation, 3 days and one year after operation. Incidence rate of refracture, mortality and complication rate were recorded after operation. Results:All patients were followed up for 12-60 months (mean, 27 months). Before operation and at postoperative 1 year, the vertebral bone mineral density in zoledronic acid group was (-2.3±1.5)SD and (-1.2±2.3)SD ( P<0.05), and that in basic treatment group was (-2.2±1.2)SD and (-2.1±1.1)SD ( P>0.05). At postoperative 1 year, the bone mineral density in zoledronic acid group was significantly better than that in basic treatment group ( P<0.05). At preoperative 3 days, postoperative 3 days and postoperative 1 year, the VAS was (8.6±0.8)points, (2.8±0.8)points, (2.1±0.8)points in zoledronic acid group, and was (8.5±1.1)points, (2.9±0.9)points, (3.0±2.3)points in basal treatment group; ODI was 48.7±5.3, 24.0±2.9, 22.3±3.3 in zoledronic acid group, and was 48.3±6.1, 24.5±3.8, 27.6±4.0 respectively in basal treatment group. The VAS and ODI were significantly reduced in two groups at postoperative 3 days and 1 year compared to those before operation ( P<0.05). Moreover, the VAS and ODI in zoledronic acid group were significantly lower than those in basal treatment group at postoperative 1 year ( P<0.05). At postoperative 2 years, the incidence rate of refracture in zoledronic acid group was 10.1%(18/178), significantly lower than 16.7%(43/252) in basic treatment group ( P<0.05). Mortality rate in zoledronic acid group was 5.1%(9/178), and that in basic treatment group was 6.3%(16/252) ( P>0.05). No serious complications were observed in both groups such as nerve injury or pulmonary embolism. Conclusion:For OVCF patients, zoledronic acid given after PKP can improve the bone mineral density, reduce pain, fasten function recovery, and effectively decrease the refracture rate.