Objective To provide a framework for understanding the need for a structured assessment of altered mental status (AMS) to better understand underlying causes of the mental status changes in adults and therefore potentially improve diagnostic skills and eventually management.Methods This is a prospective cohort observational study.We recruited consecutive adult patients with undifferentiated AMS at a single center tertiary care academic emergency department over 24 months.Demographical,clinical presentations,assessment approaches,cause factors,emergency treatments and outcomes were collected prospectively.Results One thousand nine hundred and thirty-four patients with AMS were recruited,this number of patients represented 5％ of the total ED census.Out of 1934 patients,1026 (53.1％) were male,908 (46.9％) were female.Mean age was (51.95 ± 15.71) years.Etiologic factors included neurological (n =641,35.0％),pharmacologic & toxicologic (n =421,23.0％),systemic and organic (n =266,14.5％),infectious (n =167; 9.1％),endocrine/metabolic (n =145,7.9％),psychiatric (n =71,3.9％),traumatic (n =38,2.1％),gynecologic and obstetric (n =35,1.9％).Total mortality rate was 8.1％ (n =156).The death rate was higher in elderly patients (≥ 60) than that in younger patients (10.8％ vs.6.9％,P =0.003).Conclusions The patient with AMS poses a challenge to physicians in ED.The most frequently encountered diagnostic category causing AMS were primary CNS disorders,intoxication,organ system dysfunction and endocrine/metabolic diseases.Fatality rate is very high.Prompt evaluation and treatment are essential to decrease the morbidity and mortality associated with this condition.

OBJECTIVE: To study the pathogenesis of the patients with allergic rhinitis diagnosed by Skin Prick Test (SPT), especially about the epidemiologic data of the involved allergens. METHOD: The data was collected from 958 patients referred to the listed three allergy center and subsequently diagnosed as allergic rhinitis by SPT. RESULT: The intermittent mild type was more prevalent in male patients (40.5%); comparably the intermittent moderate type in female patients (70.0%); in the infant patients the moderate-severe type dominated (73.7%). The positive results of SPT comprised mainly of Dermatophagoides pteronyssinus (Der. p, 98.3%), Dermatophagoides farinae(Der. f, 96.8%), and Blomia tropicalis (Blot, 73.8%). Only 1.7% of the patients was allergic to single allergen, in contrary ,the majority of patients were allergic to multiple allergens. The positive rate to Der. p and Der. f was reversely increasing with age of the patients; and contrarily the number of positive allergens was increasing along with the age of the patients. The allergy to outdoor allergen was less common, and the positive rate in skin prick test was lower than the previously reported rate in North China ,such as timothy (3.9%), birch (2.7%), ragweed (2.0%), and mugwort (1.2%). CONCLUSION Dust Mite is the predominant allergen for patients with allergic rhinitis in Guangdong province; and the positive rate to outdoor allergen is lower than that in North China.
Adolescent ; Adult ; Allergens ; analysis ; immunology ; Animals ; Antigens, Dermatophagoides ; analysis ; immunology ; Child ; Child, Preschool ; China ; epidemiology ; Cohort Studies ; Dermatophagoides pteronyssinus ; immunology ; Female ; Humans ; Male ; Middle Aged ; Mites ; immunology ; Rhinitis, Allergic, Perennial ; diagnosis ; epidemiology ; Rhinitis, Allergic, Seasonal ; diagnosis ; epidemiology ; Skin Tests ; Young Adult

OBJECTIVES: To investigate the effet of nasal septum operation combined with nasal sinuses on postoperative nasal septum. METHOD: Sixty-five patients with deflection of nasal septum complicating chronic sinusitis were underwent nasal septum and nasal sinus operations under nasal endoscope. Postoperative nasal septum recover were observed and compared with patients underwent only simple nasal septum operation. RESULT: Patients underwent nasal septum operations combined with nasal sinus, postoperative symptoms were more serious at early than simple nasal septum operations. At 3 months after operation, satisfactory degree of the former group were higher than the latter, and the former group didn't have complications such as nasal septum infection. CONCLUSION Nasal septum operations combined with nasal sinus have no harmful effect on the prognosis of nasal septum, so it was safe and reliable.
Adolescent ; Adult ; Chronic Disease ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nasal Septum ; surgery ; Paranasal Sinuses ; surgery ; Prognosis ; Sinusitis ; surgery ; Treatment Outcome ; Young Adult

In order to assess inhibitory potentials of white rose petal extracts (WRPE) on the activities of enzymes related to dermal aging according to the extraction conditions, three extraction methods were adopted. WRPE was prepared by extracting dried white rose (Rosa hybrida) petals with 50% ethanol (WRPE-EtOH), Pectinex(R) SMASH XXL enzyme (WRPE-enzyme) or high temperature-high pressure (WRPE-HTHP). In the inhibition of matrix metalloproteinase-1, although the enzyme activity was fully inhibited by all 3 extracts at 100 microg/mL in 60 min, partial inhibition (50-70%) was achieved only by WRPE-EtOH and WRPE-enzyme at 50 microg/mL. High concentrations (> or =250 microg/mL) of all 3 extracts markedly inhibited the elastase activity. However, at low concentrations (15.6-125 microg/mL), only WRPE-EtOH inhibited the enzyme activity. Notably, WRPE-EtOH was superior to WRPE-enzyme and WRPE-HTHP in the inhibition of tyrosinase. WRPE-EtOH significantly inhibited the enzyme activity from 31.2 microM, reaching 80% inhibition at 125 microM. In addition to its strong antioxidative activity, the ethanol extract of white rose petals was confirmed to be effective in inhibiting skin aging-related enzymes. Therefore, it is suggested that WRPE-EtOH could be a good candidate for the improvement of skin aging such as wrinkle formation and pigmentation.
Aging ; Ethanol ; Matrix Metalloproteinase 1 ; Monophenol Monooxygenase ; Pancreatic Elastase ; Pigmentation ; Skin Aging* ; Skin*

Anti-atherosclerosis effects of perilla oil were investigated, in comparison with lovastatin, in rabbits fed a high-cholesterol diet (HCD). Hypercholesterolemia was induced in rabbits by feeding the HCD containing 0.5% cholesterol and 1% corn oil, and perilla oil (0.1 or 0.3%) was added to the diet containing 0.5% cholesterol for 10 weeks. HCD greatly increased blood total cholesterol and low-density lipoproteins, and caused thick atheromatous plaques, covering 74% of the aortic wall. Hyper-cholesterolemia also induced lipid accumulation in the liver and kidneys, leading to lipid peroxidation. Perilla oil not only attenuated hypercholesterolemia and atheroma formation, but also reduced fat accumulation and lipid peroxidation in hepatic and renal tissues. The results indicate that perilla oil prevents atherosclerosis and fatty liver by controlling lipid metabolism, and that it could be the first choice oil to improve diet-induced metabolic syndrome.
Atherosclerosis ; Cholesterol ; Corn Oil ; Diet* ; Fatty Liver ; Hypercholesterolemia ; Kidney ; Lipid Metabolism ; Lipid Peroxidation ; Lipoproteins, LDL ; Liver ; Lovastatin ; Perilla* ; Plaque, Atherosclerotic ; Rabbits*