Objective To investigate the characteristics of arrhythmias and the efficacy and safety of oral amiodarone in uremic cardiomyopathy complicated with severe ventrieular arrhythmias.Methods 86 patients with uremic cardiomyopathy underwent ECG,ambulatory ECG and and echocardiograplly.45 of 86 palients with severe ventricular arrhythmias were orally given amiodarone(0.2g,tid×5d,0.2g,bid×5d,maintenance dose 0.2g,qd),ambulatory,ECG was followed up 10 days after amiodarone loading.Results Arrhythmias was detected in 62 of 86 patients with uremic cardiomyopathy,56 of 62 had ventricular arrhythmias,45 of 56 patients with vemricular arrhythmias was defined as severe because of frequent(＞30/h)or repetitive(＞5 couplets/24h or＞1 salvos of or＞3).48 of 62 patients were supraventrieular arrhythmias.Ventricular arrhythmias were sigrtificantly reduced in 45 partients on amiodarone treatment,28 of 45 patients were significant effective and 13 of 45 cases were effective,the efficacy is 91.1%.Systolic blood pressure and heart rate were not changed significantly after 10-day amiodarone reatment compared with that of untreatment.Only one patients experienced sinus bradycardia(45～55 beats per minute)and swspended after discontinuation of oral amiodarone.Conclusion In patients with uremic cardiomyopathy,arrhythmias were common on ambulatory recording,oral amiodarone was effective and safe for patients with severe ventricular arrhythmias.

Parkinson's disease was primarily considered to be a movement disorder affecting only the extrapyramidal system. Although the non-motor symptoms such as neuropsychiatric symptoms, dysautonomia, sleep disturbances and olfactory dysfunction, etc., were also common, they were often misdiagnosed or neglected. This paper would review the manifestation, relevant factors, pathogenesis and treatment of non-motor symptoms of Parkinson's disease.

Objective To investigate the prevalence,clinical traits and correlates of apathy in patients with Parkinson' s disease ( PD ).Methods Seventy-seven cases of PD patients and 40 health controls were recuited in the present study.Apathy was assessed using Lille Apathy Rating Scale(LARS) and related factors,such as motor function,cognition,depression,age,sex,education level,disease duration,levodopa equivalent doses (LED) and use of antipsychotic drugs were also evaluated.Four kinds of scales,Unified Parkinson' s Disease Rating Scale (UPDRS),Hoehn-Yahr staging,Montreal Cognitive Assessment (MoCA),Hamilton Depression Rating Scale (HAMD) were employed to evaluate the motor function,cogniton and depression,respectively.Results The prevalence of apathy and depression in the 77 PD patients were 49.4％ ( 38/77 ) and 46.8％ (36/77),respectively.Of the 77 PD patients,11 cases had apathy without depression (14.3％ ); 9 cases had depression without apathy( 11.7％ ) and 27 cases had apathy combined with depression( 35.1％ ).Among the PD patients with apathy,the cognitive type is the most common one,accounting for 86.8％ (33/38).There were significant statistical differences in education level,UPDRS- Ⅱ/Ⅲ scores,Hoehn-Yahr staging,MoCA and HAMD scores between apathy ( n =38 ) and no-apathy(n =39) PD patients(t =2.309,-3.144,-4.000,-3.217,2.649,-3.909,all P＜0.05).According to the unifactoral Logistic regression analysis of apathy correlates,UPDRS-Ⅱ/Ⅲ scores,HoehnYahr staging and HAMD scores were the risk factors for apathy while education level and MoCA were the protective factors for apathy.In the multiple Logistic regression analysis,HAMD scores,UPDRS-Ⅱ scores and education level were included.Conclusions The prevalence of apathy in PD patients was significantly higher than healthy controls.Apathy could be present without depression in PD patients,and was associated with education level,motor dysfunction degree,cognitive impairment and depression severity.

The medicine of critical disease is a clinical discipline that gradually sprang up in the late 1960s.Yet at present controversy still exists as to whether the discipline should be regarded as a separate one and it has not been ranked among the separate disciplines listed by the State Educational Committee. The authors, however, give an account of the customers and the cunent situation of disciplinary development of the discipline of critical disease from the petspective of a discipline. They also offer an account of the organizational structure and the form of staff of ICUs,pointing out that ICUs have 3 subjects structurally and are divided into CategoriesⅠ,Ⅱand Ⅲ. Except for ICUs in a few hospitals that are up to the level of Category Ⅱl, ICU s in most hospitals in China are lower than or just up to the level of Category Ⅰ. Then the authors give an introduction to the three forms of ICU management: open, semi-open and closed.

Objective To investigate clinical results of bilateral triceps bradhii approach in Gartland Ⅲ supracondylar fracture of humerus in children by comparing with reduction interne and plaster immobilization. Methods 102 children with Gartland Ⅲ supracondylar fracture of humerus,4 ～ 13 years old,from May 2003 to May 2009,were randomly divided into operation group and control group,51 cases separately. The operation group was treated by bilateral triceps bradhii approach, while control group was treated by reduction interne and plaster immobilization. All patients were made function exercise 4 weeks later,X-ray check periodically and followed up about 16 months with angle patronner and elbow joint function recorded. According to Flynn clinical function criteria,all patients were classified and analyzed. Results After follow-up and elbow joint function evaluation,48 cases ( 94. 1% ) show excellent and good results,3 cases(5.9% ) fair and poor in operation group,32 cases(62. 7% ) and 19 cases(37. 3% ) in control group. The differences between two groups was statistically singnificant ( P < 0. 05). Conclusion Comparing with reduction interne and plaster immobilization, bilateral triceps bradhii approach in Gartland Ⅲ supracondylar fracture of humerus in children has good clinical results and may be more effective therapy.

The medicine of critical disease is a clinical discipline that gradually sprang up in the late 1960s. Yet at present controversy still hats as to whether the discipline should be regarded as a separate one and it has not been ranked among the separate disciplines listed by the State Educational Committee. The authors, however, give an account of the customers and the current situation of disciplinary development of the discipline of critical disease ho the perspective of a discighne. They also offer an account of the organizational structure and the form of staff of ICUs, pointing out that ICUs have 3 subjects structurally and are divided into CategoriesⅠ,Ⅱ and Ⅲ. Except for ICUs in a few hospitals that are up to the level of Category n, ICUs in most hospitels in China are lower than or just up to the level of CategoryⅠ. ho the authorss give an introduction to the ho formsn of ICU management open, semi-opened-cpc ana closed.

Purpose To study the clinicopathological features, immunophenotype and differential diagnosis of spindle cell rhabdomyosarcoma in adults (SRMS).Methods The clinical,pathologic and immunohistochemical features were evaluated in 9 cases of SRMS in adults.Results Nine cases of SRMS in adults were retrieved from the pathological archive of this hospital. 7 cases were male and 2 were female. Patients age ranged from 20 to 80 years (median,45 years). The head and neck region,including the right mandible, pharyngeal portion, nasopharynx, and left maxillary,was the most commonly affected area, accounting for 44% of the cases, followed by forearm, waist, thigh, leg and testis(1 case each). Tumor size varied from 2 to 14 cm (median 5.9 cm).Histologically, all the tumors were mainly composed of cellular bands and fascicles of atypical spindlE-shaped tumor cells with a variable number of spindled or polygonal rhabdomyoblasts.In addition, focal areas reminiscent of interstitial sclerosing were presented in 2 cases, and pseudovascular structures were noted in 2 cases, loosely myxoid stroma were detected in 1 case and small solid areas with mild pleomorphic tumor cells were present, but lacking bizarre pleomorphic rhabdomyoblasts. Immunohistochemically, the tumor cells were positive for vimentin, desmin, CD99 and MyoD1; Myogenin and MSA were positive in most of the cases (6/9 and 7/9 each); The remaining antibodies(S-100, CD34,CK and HMB-45) were all negative. Follow-up information was available in all the cases, ranged from 6 months to 4 years, revealed paravenous metastases of the peritoneal cavity in one patient with testis tumor and liver metastases in one patient with leg tumour. 4 patients developed local recurrences and 2 patients died of the disease.Conclusions SRMS is a rare neoplasm in adults,and most commonly occurs in male with preferential involvement in the head and neck region. It appears a more aggressive clinical course in adults. Morphologically, SRMS in adults should be differentiated from other spindle cell tumors.

Objective To study the relationship between serum insulin-like growth factor-1(IGF-Ⅰ) levels and prostatic cancer. Methods The levels of IGF-Ⅰwas measured with immunoradiometric assay(IRMA) in 37 cases of prostatic cancer,35 cases of benign prostatic hyperplasia (BPH) and in 20 healthy subjects as controls.The serum IGF-I levels were compared to the clinical and pathological grading of the prostatic cancer.8 cases of prostatic cancer after operation have been followed up. Results The mean levels of serum IGF-I in prostatic cancer (325.6?100.8 ng/ml) were significantly higher than those in BPH (201.6?53.8 ng/ml) and healthy subjects (179.0?57.2 ng/ml) (P0.05).Statistical difference was noted before ( 315.8?87.0 ng/ml) and after (224.8? 88.4 ng/ml) PCa operation(P0.05). Conclusions The levels of serum IGF-I may be a new marker to prognose and for early diagnosis of PCa in high risk population.

The iatrogenic splenic injuries occurred in 49 patients who underwent abdominal surgery from January 2005 to January 2020; including grade I injury in 40 cases and grade Ⅱ injury in 9 patients. The normal saline-soaked gauze was placed on the wound surface of the injured spleen, then the high-frequency electric coagulator was employed for hemostasis. The bleeding was successfully stopped and the spleens were preserved without postoperative complications in all cases. The results show that moist electrothermal coagulation can be effectively and safely applied in treatment of grade I and grade Ⅱ injury iatrogenic splenic injuries, and no special equipment required.

A total of 521 patients underwent laparoscopic radical gastrectomy from January 2013 to January 2020 in the First People′s Hospital of Wenling. In 242 cases the splenomental fold was severed before dissecting the left half of omentum or spleen (pretreatment group), and in 279 cases the splenomental fold was not severed priorly (routine group). For pretreatment group the introoperative splenic injury occurred in 4 cases (1.65%), including 3 cases (1.24%) with class Ⅰ injury and 1 case (0.41%) with class Ⅱ injury; while for routine group splenic injury occurred in 24 cases (8.60%), including 22 cases (7.89%) with class Ⅰ injury and 2 cases (0.72%) with class Ⅱ injury, and the rupture of splenic capsule caused by tracting splenomental fold occurred in 19 cases(6.81%). There were significant differences in total number of splenic injuries, splenic injuries with class Ⅰ and rupture of splenic capsule caused by tracting splenomental fold between two groups ( P<0.05). The operation time of 28 cases with splenic injuries was (185±89) min, which was longer than that in 493 cases without splenic injuries [(172±95) min, P<0.05]. The results show that rupture of splenic capsule by tracting splenomental fold is main cause of splenic injury in laparoscopic radical gastrectomy and most of them are class Ⅰ injuries. To sever the splenomental fold priorly can reduce the incidence of iatrogenic splenic injury.