Postoperative X-ray films showed that the fracture healing time was averagely 5.4 months. Al of the fractures were recovered wel that subtrochanteric fractures, intertrochanteric fractures and femoral shaft fractures were al healed. There was no fracture displacement, internal fixation loosening and varus deformity. Only one case showed difficulties in nail insertion. Excellence rate of Harris hip functional scores was 88.2%postoperatively. Proximal femoral nail antirotation is a reasonable design, and the helical blade can resist the rotation and stabilize the angle. The proximal femoral nail antirotation has better effects, which is an ideal internal fixation for subtrochanteric femoral fractures.

Objective To screen the mutation and analysis its characteristics of SPG4 and SPG3A in Chinese patients with hereditary spastic paraplegia (HSP).Methods Mutation and polymorphism of the SPG4 and SPG3A were screened in the index eases of 26 autesomal dominant families (AD-HSP) and 30 sporadic cases by combination of DHPLC and sequencing analysis, then the index cases of 26 AD-HSP were further confirmed with direct sequencing.Results One novel mutation of SPG4, 1616 + 1g→t, was identified in the index ease from an AD-HSP family.Three symptomatic patients and 2 pre-symptomatic patients were found in this family by sequencing analysis.No mutation of SPG3A was detected.In addition, 8 novel SPG4 polymorphisms and 3 novel SPG3A polymorphisms were identified.Conclusions The study has broadened the mutation and polymorphism spectrums of SPG4 and SPG3A.Mutation of these two genes is less common in this group of patients.

OBJECTIVE:To study the effect and its mechanism of Fuzheng Jiedu Quyu formula(short forFuzheng formula) combined with oxaliplatin (L-OHP) on human colon cancer HT-29 cell proliferation and apoptosis. METHODS:HT-29 cells were divided into blank control group(without drugs),Fuzheng formula group(1000 mg/L),L-OHP group(31.25 mg/L)and combi-nation group (1000 mg/L Fuzheng formula+31.25 mg/L L-OHP). After cultured with corresponding drug for 48 h,MTT method was used to detect the cell proliferation;the changes of cellular morphology were observed by invert microscope;flow cytometry was used to detect the cell cycle and apoptosis rate. Proapoptotic gene Bax,apoptotic gene Bcl-2 mRNA expressions were deter-mined by real-time fluorescence quantitative polymerase chain reaction method;Bax,Bcl-2 protein expressions were assayed by Western blot. RESULTS:Compared with blank control group,cell proliferation was inhibited in L-OHP group and combination group;cell proportion was increased in S stage,G2/M stage and decreased in G0/G1 stage(P<0.05). Cell apoptosis rate in L-OHP group,Fuzheng formula group and combination group was increased;Bax mRNA and protein expression were up-regulated,Bcl-2 mRNA expression was downregulated(P<0.05);and combination group changed more obviously than the single drug groups(P<0.05). CONCLUSIONS:Fuzheng formula combined with L-OHP can inhibit HT-29 cell proliferation and promote its apoptosis, showing better effects than either of the two drugs alone. The mechanism may be associated with up-regulation of Bax gene and pro-tein expressions and down-regulation of Bcl-2 gene expressions in cells.

Objective To study the prevalence of hypertension in a Beijing urban population aged 6074 years and to analyze the characteristics of hypertension distribution. Methods A(cross-sectional) study was carried out in the population consisting of 1175 people,and data of blood pressure,glucose,lipid and obesity were analyzed. Results (1) The age-adjusted prevalence of hypertension was 60.5% in the Beijing elderly population.About two thirds of the hypertensive cases were taking prescribed medication(60.9%).Only one quarter of hypertension was controlled successfully(23.4%).(2)Compared with 60-64 age group,the prevalences of hypertension of 70-74 age group was increased by 30.3% in man and by 32.1% in women.(3) The prevalence of isolated systolic hypertension in the elderly was 25.0%,accounting for 42.3% of hypertension in the elderly population.(4) Eighty-six percent of all elder hypertensive patients had one and more cardiovascular risk factor and more in addition to hypertension itself. Conclusions High blood pressure is a popular disease of cardiovascular disorders in Beijing elderly population.Isolated systolic hypertension is the main hypertension subtype in the elderly.Most of the elderly hypertension patients combine other cardiovascular disease risk factors.

OBJECTIVETo study the trends of incidence on acute intracerebral hemorrhage events and acute cerebral infarction events in the population aged 25 - 74 in urban areas of Beijing from 1984 to 1999.

METHODSIn monitoring the trends and determinants in the cardiovascular disease (MONICA) project and subsequent study, acute intracerebral hemorrhage events and acute cerebral infarction events were registered in a standardized way in men and women aged 25 to 74 years from 1984 - 1999.

RESULTSBoth intracerebral hemorrhage attack rates decreased but cerebral infarction attack rates increased significantly; The proportion of intracerebral hemorrhage events in stroke events decreased from 42.0% to 16.0% while the proportion of cerebral infarction events in stroke events increased from 55.8% to 81.6%, the changes in incidences of acute intracerebral hemorrhage events and acute cerebral infarction events in various age groups were different.

CONCLUSIONCerebral infarction was the most important risk causing stroke, so prevention of cerebral infarction should be strengthened in the area.

Acute Disease ; Adult ; Age Factors ; Aged ; Cerebral Hemorrhage ; epidemiology ; Cerebral Infarction ; epidemiology ; China ; epidemiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Sex Factors

Objective:To investigate the correlation between triglyceride-glucose (TyG) index and high on-treatment platelet reactivity (HTPR) during clopidogrel treatment in patients with ischemic stroke.Methods:Patients with ischemic stroke who received maintenance dose of clopidogrel (75 mg/d) in the Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine from January 2017 to March 2021 were retrospectively included. The highest quartile (Q4) of the TyG index was defined as insulin resistance. Platelet reactivity was assessed by thromboelastogram and clopidogrel HTPR was defined as the clot strength induced by adenosine diphosphate (MA ADP) >47 mm. Multivariate regression model was used to analyze the independent correlation between TyG index and platelet reactivity. Results:A total of 83 patients were included. The TyG index showed a linear correlation with MA ADP. The patients were divided into 4 groups according to the quartile of TyG index. The incidence of clopidogrel HTPR increased significantly with the increase of the quartile of the TyG index ( Ptrend=0.017). Multivariate analysis showed that there was a significant independent correlation between insulin resistance and clopidogrel HTPR (odds ratio 4.597, 95% confidence interval 1.285-16.446; P=0.019). Conclusions:In patients with ischemic stroke treated with clopidogrel, the incidence of clopidogrel HTPR gradually increases with the increase of the quartile of the TyG index. The insulin resistance assessed by the TyG index is independently associated with clopidogrel HTPR.

Essential palatal tremor is relatively rare in clinical practice, which manifests involuntary and rhythmic contraction of soft-palate along with auditory click. The cause is unknown and there is no specific treatment at present. This article reports a female patient with essential palatine tremor, who presented with involuntarily beating of soft palate, disappeared during sleep, had sensory tricks, and gradually developed mental and psychological problems such as anxiety disorders. After treatment with integrated traditional Chinese and Western medicine, the symptoms improved. The clinical features of the case were analyzed, relevant literature was reviewed, and the possible etiology and characteristics of the disease were explored, so as to provide reference for clinical diagnosis and treatment.

OBJECTIVETo Study the temporal patterns of stroke onset, and to provide insights into the triggers which might cause the acute onset of stroke and to develop preventive strategies.

METHODSUsing a 10-year period of the SINO-MONICA-Beijing study cohort a total number of 700 000 people, aged 25 to 74 years was recruited. The diagnostic criteria exactly followed the WHO MONICA project. Date of the week, season and month occurrence of stroke were ascertained. Percentage of stroke onset on date in the week, season and month were calculated. chi(2) test was used to identify the deviation from expected frequencies. Multiple stepwise regression was carried out for multivariate analysis.

RESULTSMost stroke occurred and recurred (chi(2) = 7.02, P = 0.008 in male and chi(2) = 12.32, P = 0.000 4 in female) in winter. The most frequent occurrence on the dates of stroke events were Monday in the urbans and Saturday in the rurals. The finding were confirmed (the stroke occurrence and recurrence positively correlated with season, correlation coefficient 0.032, P = 0.01) by correlation and multiple stepwise regression.

CONCLUSIONIt was important to find out the circadian variation and the external triggering factors together with unhealthy behaviour of life that would contribute to the prevention and reduction of stroke onset.

Adult ; Aged ; China ; epidemiology ; Cohort Studies ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Seasons ; Stroke ; epidemiology

Objective:To summarize and analyze the clinical data of Chinese patients with colony-stimulating factor 1 receptor (CSF1R)-related leukoencephalopathy, and clarify the phenotypic and genetic characteristics of Chinese patients.Methods:Medical history of patients with CSF1R-related leukoencephalopathy diagnosed from April 1, 2018 to January 31, 2021 in the department of neurology of 22 hospitals in China was collected, and scores of Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment Scale (MoCA), magnetic resonance severity scale were evaluated. Group comparison was performed between male and female patients.Results:A total of 62 patients were included, and the male-female ratio was 1∶1.95. The age of onset was (40.35±8.42) years. Cognitive impairment (82.3%, 51/62) and motor symptoms (77.4%,48/62) were the most common symptoms. The MMSE and MoCA scores were 18.79±7.16 and 13.96±7.23, respectively, and the scores of two scales in male patients (22.06±5.31 and 18.08±5.60) were significantly higher than those in females (15.53±7.41 , t=2.954, P=0.006; 10.15±6.26, t=3.328 , P=0.003). The most common radiographic feature was bilateral asymmetric white matter changes (100.0%), and the magnetic resonance imaging severity scale score was 27.42±11.40, while the white matter lesion score of females (22.94±8.39) was significantly higher than that of males (17.62±8.74 , t=-2.221, P<0.05). A total of 36 CSF1R gene mutations were found in this study, among which c.2381T>C/p.I794T was the hotspot mutation that carried by 17.9% (10/56) of the probands. Conclusions:The core phenotypic characteristics of CSF1R-related leukoencephalopathy in China are progressive motor and cognitive impairment, with bilateral asymmetrical white matter changes. In addition, there exist gender differences clinically, with severer cognitive impairment and imaging changes in female patients. Thirty-six CSF1R gene mutations were found in this study, and c.2381T>C/p. I794T was the hotspot mutation.

BACKGROUNDAlthough there were criteria for diagnosis of neuromyelitis optica (NMO) and multiple sclerosis (MS), it is still difficult to differentiate NMO from MS, due to the overlapping clinical manifestations. Therefore it is necessary to characterize clinical features of NMO and MS patients in the mainland of China, to simplify the process of disease diagnosis, and to identify criteria for the differential diagnosis of NMO and MS.

METHODSA total of 138 Chinese Han patients from the mainland of China including 73 NMO, 60 MS and 5 MS-like patients with positive NMO-IgG were included in the study. Clinical records were reviewed retrospectively and the results of clinical examination, laboratory experiments, magnetic resonance imaging (MRI) and evoked potentials (EPs) were compared between NMO and MS patients. In addition, the relationship between the NMO-IgG serologic status and clinical characteristics were analyzed.

RESULTSCompared with MS patients (1.3: 1.0), more female prevalence was observed in NMO patients (4.2: 1.0; P = 0.003). There were also statistically significant differences in visual EPs, oligoclonal bands, brainstem lesions in MRI and longitudinally extensive spinal cord lesions (LESCLs) between NMO and MS patients. Brainstem lesions observed in brain MRI were found in 17.9% of MS patients, over 3.7 times higher than in NMO patients (4.8%, P = 0.024). When stratified NMO patients by NMO-IgG, LESCLs were found in 42.1% of NMO-IgG-negative NMO patients, over 3.5 times higher than in NMO-IgG-positive patients (11.9%, P = 0.008). Statistical difference was also observed in CD4+/CD8+ ratios between NMO-IgG-positive and -negative NMO patients.

CONCLUSIONSComprehensive analysis of MRI, laboratory and EPs data can facilitate differential diagnosis of MS and NMO. In addition, the combination of LESCLs and brain MRI findings failing to satisfy MRI criteria for MS is highly sensitive and specific for NMO.

Adult ; China ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Multiple Sclerosis ; diagnosis ; Neuromyelitis Optica ; diagnosis ; Retrospective Studies