To evaluate the effect of endoscopic treatment of pancreatic ductal stones (PDS), 31 patients with PDS treated in our hospital from January 1998 to Octomber 2001 were analyzed retrospectively. PDS were successfully extracted in 10 patients by endoscopic papillotomy (EPT) or endoscopic pancreatic sphincterotomy (EPS). In 2 patients, one was treated with extracorporeal shock wave lithotripsy (ESWL) and endoscopic retrograde pancreatic drainage (ERPD), another with EPS and ESWL, the PDS were all disappeared in 6 months. Fourteen patients with pancreatic ductal stricture were treated with ERPD, and 4 with EPS+ERPD. However, 4 patients were subjected to operation for pancreatic carcinoma and recurrent symptom. Only one of them failed owing to severe pancreatic ductal stricture. The success rate of the procedure was 96 8%, and the remission rate of abdominal pain was 90% shortly after operation and 70 4% in the follow up interval. The body weight and pancreatic exocrine function were also improved. But the stent occlusion was found in 3 patients and their stents were changed. So endoscopic therapy such as EPS, ESWL, and ERPD are effective and safe methods in treatment of PDS.

Objective To study the availability of escharectomy in shock phase and its role in preventing complications.Methods To make an analysis between the escharectomies and skin grafting of 79 cases in or beyond shock phase in the incidence of sepsis,visceral complications,MODS,mortality,healing time and the expenditure.Result The cases of the early operations revealed much better consequences than those performed beyond shock phase.Conclusion The escharectomy in shock phase proves to be available and significant in reducing post burn complications.

Objective To evaluate the possible white matter damage and to define the location of the damage in Alzheimer′s disease (AD) with diffusion tensor imaging (DTI). Methods Twenty-four AD patients and twenty-one age-matched healthy volunteers received conventional and DTI scanning.The ADC and FA of white matter in temporal, parietal, frontal lobe and cingulum were measured respectively and the data underwent postprocessing.Results FA value of the whiter matter in frontal, parietal, temporal and cingulum in AD patients was 0.37?0.06, 0.32?0.05, 0.26?0.03, and 0.47?0.09, respectively, and ADC value was 9.50 e-10?2.02 e-10, 10.55 e-10?1.43 e-10, 11.45 e-10?0.76 e-10, and 10.10 e-10?2.18 e-10, respectively;FA value of the same corresponding regions in control was 0.44?0.06, 0.38?0.05, 0.32?0.05, and 0.56?0.06, respectively, and ADC value was 8.75 e-10? 1.63 e-10, 9.83 e-10?0.99 e-10, 11.13 e-10?0.78 e-10, and 8.28 e-10?1.65 e-10, respectively.FA value of the whiter matter in frontal, parietal, temporal, lobe and cingulum decreased (P≤0.006) and ADC value increased in cingulum white matter (P≤0.006) in AD patients.Conclusion DTI could reveal the damage in white matter of frontal, temporal, parietal lobe and cingulum.It suggested that not only the gray matter is injuried, but also the white matter is abnormal in AD patients.

OBJECTIVETo investigate the effect of delayed skin grafting combined traction in severe joint cicatricial contracture.

METHODSAt the first stage, the joint cicatricial contracture was released completely with protection of vessels, nerves and tendons. The wound was covered with allogenetic skin or biomaterials. After skin traction for 7-14 days, the joint could reach the extension position. Then the skin graft was performed on the wound. 25 cases were treated from Mar. 2000 to May. 2013.

RESULTSPrimary healing was achieved at the second stage in all the cases. The skin graft had a satisfactory color and elasticity. Joint function was normal. All the patients were followed up for 3 months to 11 years with no hypertrophic scar and contraction relapse, except for one case who didn' t have enough active exercise on shoulder joint.

CONCLUSIONDelayed skin grafting combined traction can effectively increase the skin graft survival rate and improve the joint function recovery.

Biocompatible Materials ; therapeutic use ; Cicatrix, Hypertrophic ; Combined Modality Therapy ; methods ; Contracture ; surgery ; Female ; Humans ; Male ; Recovery of Function ; Recurrence ; Skin Transplantation ; methods ; Tendons ; Traction ; methods ; Wound Healing

AIM: To study the efficacy and safety of dispersible formulation of levodopa-benserazide on the parkinson disease.　METHODS: The multicenter, open-label, self-controlled trial was conducted at 23 hospitals in 15 cities. Two hundred and four patients with idiopathic parkinson who had received standard levodopa-benserazide previously participated in this study. Dispersible levodopa-benserazide instead of standard levodopa-benserazide for 8 wk as a course. The Webster rating scale and patient diary were applied to assess the efficacy and safety of dispersible levodopa-benserazide.　RESULTS： The medication with dispersible levodopa-benserazide increased “on” time by 47 min, decreased “off” time by 11 min, and speeded the onset of “on” time by 37 min. The Webster score was improved by 25 %. Statistical significant difference was calculated (P<0.01). Slight and few adverse reactions were found.　CONCLUSION: Dispersible formulation of levodopa-benserazide is a powerful anti-parkinsonian drug characterized by oral easy use and rapid reach to therapeutic action after ingestion. This drug is particularly used in the parkinsonian patients with morning akinesia, delayed onset of “on” time, afternoon “off” status and dysphagia.

Objective To investigate the incidence rate, onset time and electrophysiological characteristics of rapid eye movement sleep behavior disorder (RBD) and the relationship between RBD and synucleinopathies as well as the electrophysiological diagnostic criteria of RBD in Parkinson' s disease (PD) and multiple system atrophy (MSA). Methods Sleep survey and night video-polysomnography (NPSG)were used to study sleep disturbance of PD and MSA. (1) Subjective sleep assessments: All subjects,including 66 PD patients, 65 age and sex matched healthy controls and 30 MSA patients, completed the sleep questionnaires, and the RBD incidence rate and onset time were got. (2) Objective sleep assessments: 8 PD patients, 13 MSA patients, and 15 age and sex matched healthy controls underwent video-NPSG recording on two consecutive nights. Sleep architect were analyzed. The NPSG characteristics of RBD accompany with PD and MSA were analyzed, and the electrophysiological diagnostic varameters of it were determined. Results Patients with PD or MSA had a higher prevalence of RBD. RBD was found in 59. 1% (39/66) PD patients and 86. 6% (26/30) MSA patients, among those, 46. 2% ( 18/39 ) and 84.6% (22/26) had the waking symptoms of MSA and PD. The main NPSG characteristics of RBD of PD or MSA were chin REM without atonia (RWA) and increased movement. Conclusions The relatively higher RBD prevalence in MSA and PD patients indicates that RBD has close relationship with PD and MSA.Part of patients with RBD preceding neurology disease indicates that RBD may be the early marker of PD and MSA. The main NPSG characteristics of RBD accompany with PD and MSA are chin RWA and the motor manifestations. RWA and phasic EMG activity density are supposed to be the NPSG diagnostic parameters.

Objective To study the efficacy and safety of entacapone as an adjunct to levodopa treatment in pakinsonian patients with wearing-off motor fluctuations. Methods A total 209 pakinsonian patients with end-of-dose deterioration participated in a multi-center,12-weeks randomized,placebo-controlled,double blind,parallel-group trial.The efficacy of entacapone was assessed using the patient’s diary card,the Unified Parkinson’s Disease Rating Scale (UODRS) score,the daily levodopa dosage,and the global assessment of changes.Results 96.2% of the entacapone and 92.4% of the placebo-treated patients completed the study.In 209 cases of the ITT population,in comparison to the placebo-treated patients,entacapone had increased the mean “on” time (h/d) from 7.4?1.8 in base-line to 9.1?2.5 in week 12,decreased the “fof” time (from 6.8?2.2 in base-line to 5.2?2.8 in week 12),improved the motor scores (from 36.7?11.3 in base-line to 30.0?14.4 in week 12),and reduced the levodopa dose (from 589.2?264.3 in base-line to 561.5?248.1 in week 4). The improvement was also evident on impression of successful treatment for 69.9% of neurologists through global change assessment.There was no significant difference in the frequency of dopaminergic adverse events and serious laboratory abnormalities between entacapone and placebo groups.Conclusion The results of this study demonstrate that entacapone,the COMT inhibitor is a safe and effective extender of levodopa treatment for Parkinson’s disease patients with motor flucturations.

OBJECTIVE: To observe the changes of distortion product otoacoustic emissions (DPOAE) in the patients with iron deficient anaemia (IDA). METHOD: Sixty cases who were taken health physical examination at ZhaBei District Central Hospital were divided into two groups, the normal group (30 cases, 60 ears) and the IDA group (30 patients, 60 ears) depend on the results of examination of hemoglobin and serum ferritin. The changes of DPOAEs at 4 kHz were observed. RESULT: A statistically significant decrease of DPOAE threshold level compared with the normal controls was seen at 4 kHz in the patients with IDA. CONCLUSION The decreased threshold level of DPOAE at 4 kHz in IDA patients should relate to sensorineural hearing loss directly.
Adolescent ; Adult ; Aged ; Anemia, Iron-Deficiency ; blood ; physiopathology ; Audiometry, Pure-Tone ; Auditory Threshold ; Case-Control Studies ; Cochlea ; physiopathology ; Female ; Ferritins ; blood ; Hemoglobins ; analysis ; Humans ; Male ; Middle Aged ; Otoacoustic Emissions, Spontaneous ; Young Adult

Objective:To evaluate the clinical outcomes of traumatic spinopelvic dissociation treated with robot-assisted bilateral triangular fixation.Methods:From March 2016 to March 2020, 30 patients with traumatic spinopelvic dissociation were retrospectively analyzed. According to operation and fixation methods, the patients were divided into robot-assisted minimally invasive bilateral triangular fixation group (Robot triangular group) and traditional open reduction lumbopelvic fixation group (Lumbopelvic group). There were 16 patients in the Robot triangular group, 4 males and 12 females, average age 35.7±13.3 years (range, 16-58 years). There were 10 cases of U-shaped, 4 cases of H-shaped, 2 cases of Y-shaped sacral fractures according to shape classification of sacral fractures. According to ROY-Camille classification, there were 4 cases of type I, 9 cases of type II, 3 cases of type III. There were 13 cases with sacral nerve injuries, including 10 cases of Gibbons grade II, 3 cases of grade III. There were 14 patients in the Lumbopelvic group, 4 males and 10 females, average age 37.4±15.1 years (range, 18-66 years), there were 10 cases of U-shaped, 3 cases of H-shaped, 1 case of Y-shaped sacral fractures according to shape classification of sacral fractures. According to ROY-Camille classification, there were 1 case of type I, 10 cases of type II, 3 cases of type III. There were 10 cases with sacral nerve injuries, 7 cases of Gibbons grade II, 3 cases of grade III. The patients' age, operation time, intraoperative blood loss, and Majeed score of the two groups were compared by independent sample t-test; gender, sacral fracture classification, ROY-Camille classification, fracture reduction quality, postoperative wound infection, and sacral nerve recovery were compared by Chi-square test. Results:All patients were followed up for 23.6 months (range, 12-54 months). In the Robot triangular group, the operation time was 95.3±27.5 min (range, 70-180 min), and intraoperative blood loss was 98.7±47.5 ml (range, 50-250 ml). According to Mears and Velyvis imaging evaluation criteria, anatomical reduction was achieved in 6 cases, satisfactory reduction was achieved in 9 cases and unsatisfactory reduction in 1 case. The Majeed score was 85.5±7.7 points. 8 cases of Gibbons grade II sacral nerve injury were recovered to grade I after surgery, 1 case of grade III recovered to grade I, and 1 case recovered to grade II. In the Iliolumbar fixation group, the operation time was 148.6±59.1 min (range, 90-240 min), and intraoperative blood loss was 582.1±244.6 ml (range, 300-1 200 ml). According to Mears and Velyvis imaging evaluation criteria, anatomical reduction was achieved in 7 cases, satisfactory reduction was achieved in 6 case and unsatisfactory in 1 case. The Majeed score was 77.6±7.7 points. 5 of 7 cases of Gibbons grade II sacral nerve injury were recovered to grade I after surgery, and 2 of 3 cases of grade III recovered to grade I. Compared with the Iliolumbar fixation group, the Robot triangular group has shorter operation time ( t=3.23, P<0.05), less bleeding ( t=7.76, P<0.05), and higher postoperative Majeed score ( t=2.83, P<0.05). There are statistical differences in the above indicators significance. Conclusion:For traumatic spinopelvic dissociation, especially fractures involving the lumbosacral junction, those who do not require sacral nerve decompression, Robot-assisted bilateral triangular fixation shows satisfactory clinical outcomes, which is minimally invasive, with fewer postoperative complications.

Brain ; pathology ; China ; Humans ; Organ Preservation ; standards ; Tissue Banks ; ethics ; standards