Objective To investigate the cognitive impairment characteristics in Parkinson's disease (PD) with mild cognitive impairment(PD-MCI)as well as their related risk factors.Methods In all of the participants, a battery of neuropsychological tests were selected to identify the cognitive deficits; the 2 cognitive screening tests utilized in this study were the MMSE and the CAMCOG-C; the severity of disease was measured using the Hoehn-Yahr;the motor portion of the UPDRS and Webster scale were used to evaluate motor function and PD-MCI were classified according to modified Petersen's criteria.Results Of the 89 PD cases, 56 (63%) were cognitively normal (PDCOGNL), 20 (22%) had MCI and 13 (15%) met criteria for PD dementia (PDD). The cognitive domain abnormal in PD-MCI was orientation, language, memory, attention, praxis, thinking and perception. The PDCOGNL group had no significant differences in age and PD onset versus the PD-MCI group, but had significant difference in the years of education (PD-MCI:4.4±4.3,PDCOGNL:7.1±4.9;q=3.270, P<0.05); PD-MCI also had no significant differences for all of them versus the PDD, but the PDD group had significant differences for them (q=-4.913, -4.997, 4.740,all P<0.01) compared with the PDCOGNL group; there were no significant differences among 3 groups in years of PD duration. Hoehn-Yahr and Webster scale, UPDRS-motor score had negative correlation with PD cognitive function. Conclusions A stage of clinical cognitive impairment in PD can be defined between PDCOGNL and PDD that characterized as PD-MCI. There are multiple domains impaired in PD-MCI. The risk factors of PD cognitive impairment include the elder, later onset and lower education level. There are negative correlation between the severity of disease, motor function and PD cognitive function.

Endocarditis, Bacterial ; Female ; Humans ; Hypertension, Pregnancy-Induced ; Pregnancy

Objective To compare the glycemic control of different management approaches in type 1 diabetic mellitus (T1 DM) children,and to evaluate the influence factors associated with glycemic control.Methods This survey included 68 T1DM children from January 2012 to December 2014 in the Affiliated Hospital of Qingdao University of more than 1 year management.Hemoglobin A1c (HbA1c) levels were detected to assess glycemic control.Twenty-three T1DM children who participated in the World Diabetes Foundation(WDF) management program (group A) were compared with 45 T1DM children who were managed by themselves (group B).The clinical data were analyzed to explore the correlations with glycemic control.Results The HbA1c of 68 children was (8.86 ± 2.00)％,and only 21 cases (30.9％) had optimal HbAlc (HbAlc ＜ 7.5％).The level of HbA1 c of group A (7.60 ± 1.57)％ was significantly lower than that of group B[(9.40 ± 1.91) ％] (t =-4.045,P =0.001).Group A had less fluctuation in blood glucose than group B,which the duration more than 3 years.Duration (F =2.277,P =0.004),frequency of self-monitoring blood glucose (F =9.375,P =0.001),diabetic education (F =3.276,P =0.002),and diabetic diet (t =-2.046,P =0.025) were associated with glycemic control.Conclusions The glycemic control of T1 DM children at the Affiliated Hospital of Qingdao University was at the medium level,most of them haven't reached the target levels.The WDF management program could significantly and continuously monitor the glycemic level.Diabetic education and more frequent self-monitoring blood glucose and diabetic diet are associated with better glycemic control.

ObjectiveTo evaluate the safety and efficacy of tirofiba in the treatment of patients with acute ST-elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI). MethodsA total of 158 patients with acute STEMI were randomly divided into tirofiban group 1 (59 cases, received tirofiban before PCI), tirofiban group 2 (56 cases, received tirofiban when PCI) and control group(43 cases, only received PCI). The coronary reperfusion flow(TIMI grade) of infarct related artery (IRA) after PCI, the resolution of the sum of ST segment elevation(sum STR) at 90 min after the procedure, the changes of myocardial enzyme at 6 h and 12 h afterwards, the left ventricular ejection fraction (LVEF) 1 week later, the major adverse cardiac events(MACE) within 30 d, bleeding and thrombocytopenia complications were analyzed and compared among the three groups. ResultsTIMI reperfusion grades in tirofiban group 1[98.3％(58/59 )]and tirofiban group 2[92.9％(52/56)]were higher than those in control group[60.5％(26/43)](P ＜0.05). The resolution of sum STR at 90 min after PCI in tirofiban group 1 [(89.3 ± 6.9)％]and tirofiban group 2[(82.4 + 7.3)％]was higher than that in control group[(65.6 +8.1 )％](P＜ 0.01 ),and there was significant difference between tirofiban group I and tirofiban group 2 (P＜0.05 ). The occurrence of MACE within 30 d was lower in tirofiban group 1 and tirofiban group 2 than that in control group (P＜ 0.05). The level of CK-MB at 6 h and 12 h afterwards was lower in tirofiban group 1 than that in tirofiban group 2,and tirofiban group 2 was lower than control group (P＜ 0.05). LVEF 1 week later in tirofiban group 1[(56.2 + 6.4)％]was higher than that in tirofiban group 2[(51.1 + 4.9)％]and control group[(49.8 + 5.7)％](P ＜ 0.05),but there was no significant difference between tirofiban group 2 and control group (P ＞ 0.05). Although bleeding incidence in tirofiban group 1 and tirofiban group 2 was higher than that in control group, no severe bleeding and thrombocytopenia was observed. Conclusion Tirofiban can safely and effectively reduce the incidence of the ischemic events in the patients with acute STEM1 during preoperative of emergency PCI.

Background: Postoperative gastroparesis syndrome (PGS) is a common complication after abdominal surgery in patients with primary liver cancer. However, surgeons usually do not have effective treatment for them. Objective: To explore the effects of acupuncture applied to Zusanli and other acupoints on PGS in patients after abdominal surgery. Design, setting, participants and interventions: Sixty-three PGS patients of abdominal surgery, from Eastern Hepatobiliary Surgical Hospital, were randomized into acupuncture group (32 cases) and metoclopramide group (31 cases). The patients in acupuncture group were treated with acupuncture applied to Zusanli and other acupoints once a day, while the patients in metoclopramide group were intramuscularly injected 20 mg metoclopramide three times a day. Main outcome measures: Volume of gastric drainage, number of treatment and cure rate in the two groups were measured and evaluated. Results: Acupuncture and metoclopramide could significantly reduce gastric drainage volume. In acupuncture group, the cure rate was 90.6% and the number of treatment was 6.58+/-4.26, while in metoclopramide group, the cure rate and the number of treatment were 32.3% and 10.13+/-3.60 respectively. There were significant differences in gastric drainage volume, cure rate and number of treatment between the two groups (P<0.05, P<0.01). Conclusion: Acupuncture is a good treatment for PGS, with fewer treatments, high cure rate and rapid effect.

Abnormalities, Multiple ; diagnosis ; genetics ; Child ; Chromosome Deletion ; Chromosomes, Human, Pair 22 ; genetics ; Female ; Genetic Testing ; Humans ; Karyotyping ; Mutation ; Ring Chromosomes

objective:To study the etiopathogenisis、clinical features、diagnosis and treatments of monostotic fibrous dysplasia of the sphenoid sinus. Method:Two cases of monostotic fibrous dysplasia of the sphenoid sinus without any symptoms was reported with relevant literature review.Result: No aggravation was found after 6 months-follow-up.Conclusion:The cranial fibrous displasia has low incidence rate with non-specific symptoms and high rate of misdiagnosis. The monostotic fibrous dysplasia of the sphenoid sinus without any symptom is rarely seen clinically. Imageological examination,for example,CT and MRI,is valuable for the diagnosis of this disease. The histopathological evidence is absolutely necessary to make definite diagnosis. The conservative treatment may be chosen for the asymptomatic cases. Nasal Endoscopic surgery can not only remove the diseased region but also make diagnosis.The long-term follow-up should be carried out in all of these patients.

Objective To explore the significance of changes of matrix metalloproteinase-9 (MMP-9),interleukin-6 (IL-6),and tumor necrosis factor-alpha (TNF-oα) protein level in the cerebrospinal fluid (CSF) of children with viral encephalitis (VE).Methods The concentration of neuron-specific enolase (NSE),structural proteins 100B (S100B),and MMP-9,IL-6,TNF-α in the CSF of VE children were detected by an enzyme linked immunosorbent assay,and the correlations of them were analyzed.Results NSE,S100B,MMP-9,IL-6,TNF-α protein expression could be found significantly higher than those in the control group,and there were significant differences according to statistics expression trends(all P ＜0.05).The NSE protein expression was significantly positive related with S100B in the VE group (r =0.467,P =0.009),and the concentration was markedly negative related with the duration of viral encephalitis (r =-0.472,P =0.008).MMP-9,IL-6 protein expression were significantly positive related with NSE,S100B respectively (r =0.698,P =0.00 ; r =0.559,P =0.00 ; r =0.812,P =0.00 ; r =0.664,P =0.00).TNF-α protein expression was positive related with CSF S100B(r =0.363,P =0.049),but there was no correlation between TNF-α and NSE (r =0.245,P =0.193).Conclusions The neurons and the neuroglial cells are damaged in the viral encephalitis children.MMP-9,IL-6,TNF-α protein may participate in the pathological damage process of nerve cells in VE children in different degrees.

Objective To study the left atrial appendage (LAA) function and haemodynamics by transesophageal echocardiography,and predict high risk of thrombosis.Methods Eighty-nine consecutive patients were studied using transesophageal echocardiography.According to with spontaneous echo contrast (SEC) or not,all patients were divided into SEC group (n =17) and non-SEC group (n-=72).LAA emptying peak flow velocity (LAA-EV),filling peak flow velocity (LAA-FV) were measured by pulsed Doppler.The middle segment of the LAA medial wall systolic peak velocity (LAA-TSV) and diastolic peak velocity (LAA-TDV) were obtained by tissue Doppler imaging.LAA color Doppler and M-mode color Doppler images were acquired and derived the LAA emptying flow propagation velocity (LAA-EPV).Results LAA-EV,LAA-FV,LAA-TSV,LAA-TDV,LAA-EPV of SEC group were lower than those of non-SEC group (P ＜0.05).LAA M-mode color Doppler had four characteristic patterns,N pattern (normal pattern) which flow eject from LAA apical to LAA orifice,R pattern (reverse pattern) which flow eject from LAA orifice to LAA apical,V pattern (vertical pattern) vertical signals seen in systole and without efficient flow,S pattern (stasis pattern) almost no flow signal.V,R and S patterns may indicate high risk of SEC and thrombosis.LAA-EPV had strong correlation with LAA-EV (r =0.742,P ＜0.001),and moderate correlation with LAA-TSV (r =0.462,P ＜0.01),LAA-EV had strong correlation with LAA-TSV (r =0.600,P ＜0.01).Conclusions LAA dysfunction would result in hypokinetic LAA wall motion and reduced blood flow velocity.Emptying abnormalities of LAA might be the important reasons for blood stasis and thrombus formation.Emptying characteristic low patterns of V,R and S might be novel methods to predict high risk of thrombus.