Objective To evaluate the changes parameters of polysomnographic ( PSG) with different subtypes of primary Parkinson's disease ( PD ) and analyze the clinical characteristics of sleep disorders in PD patients. Methods Ninety patients with primary PD [ tremor-predominant PD group ( n = 40 ) , postural instability gait disorder ( PIGD )-predominant PD group ( n = 50 ) ] and 50 healthy controls were detected by full night PSG monitoring. And the results were compared. Results Compared with tremor-predominant PD group, the total sleep time, bed time, sleep wake-up times, sleep efficiency and rapid eye movement ( REM ) sleep time of PIGD-predominant PD group were significantly lower (all P<0. 05), however, the sleep latency, S1 (min), S1 (%), S2 (min), S2 (%), S3+S4(min), S3+S4 (%) had no statistical significance (all P>0. 05). Compared with the controls, the total sleep time and bed time of tremor-predominant PD group were significantly lower (all P<0. 05), however, the sleep wake-up times, sleep efficiency, REM sleep time, sleep latency, S1 ( min ) , S1 (%) , S2 (min), S2 (%), S3 + S4 (min), S3 + S4 (%) had no statistical significance (all P>0. 05). Combined with video surveillance video observation,the abnormality of REM sleep behavior disorder ( RBD) was 70% with PIGD-predominant PD group, in which the abnormality of tremor-predominant PD group was 2. 5%. Conclusions The PIGD-predominant PD patients are more likely to appear sleep disorders and RBD than tremor-predominant PD patients. It may be related to clinical heterogeneity of different PD subtypes.

Objective: To establish an HPLC method for the determination of codonoposide in Codonopsis lanceolata Benth. et Hook.F..Methods:The HPLC analysis was performed on a Kromasil C18column (250 mm×4.6 mm,5 μm). The mobile phase was 0. 1% phosphoric acid-acetonitrile (70∶ 30) and the flow rate was 1. 0 ml·min-1 . The detection wavelength was 203 nm and the column temperature was 30℃. Results:Codonoposide in Codonopsis lanceolata Benth. et Hook. F. had a good separation from the oth-er components, and a good linear relationship was obtained within the range of 1. 09-17. 41 μg( r=0. 999 9). The average recovery was 98. 46%(RSD=1. 64%, n=6). Conclusion: The method is practicable with promising repeatability, which can be applied in the content determination of codonoposide in Codonopsis lanceolata Benth. et Hook. F. .

Objective To explore the MRI characterisitics of primary dilated cardiomyopathy and isolated left ventricular non-compaction.Methods The patients who were diagnosed as primary dilated cardiomyopathy (n=18) and isolated left ventricular non-compaction (n=10) were enrolled,and the MRI was performed.The thickness of non-compaction myocardium (NC),compaction myocardium (C) in end-diastole,the feature of movement of myocardium,the number of non-compaction segment,the fraction shortening of non-compaction and the distribution were compared.Results Totally 823 segments were analyzed in primary dilated cardiomyopathy,in which 124 segments were non-compaction myocardium;397 segments were analyzed in isolated left ventricular non-compaction,in which 115 segments were non-compaction myocardium.The NC,NC/C,NC/(NC+C),and the fraction shortening of the isolated left ventricular non-compaction patients were higher than those of primary dilated cardiomyopathy patients (all P＜0.05).The features of distribution showed that the apical segment was mostly involved,and the basal segment was less involved or hardly involved.The anterior and lateral segments were more involved in the free wall,the septal was less involved.Conclusion The MRI characteristics of primary dilated cardiomyopathy and isolated left ventricular non-compaction are different,especially in the distribution,non compacted segments,NC and NC/C,which is important for diagnosis and differential diagnosis of the two diseases.

OBJECTIVE: To determine the biological activity of ellagic acid extracted from gallnut against nasopharyngeal carcinoma and its molecular mechanism. METHODS: Nasopharyngeal carcinoma 5-8F cells were treated with 2, 4, 6 μg/mL ellagic acid for 48 h in vitro. The cell proliferation and cell apoptosis were analyzed by MTT and Hoechst33258 stain. The cell cycle and protein expression were measured by flow cytometry and Western blot. RESULTS: Ellagic acid inhibited the proliferation of 5-8F cells. The inhibition rates were (29.35±4.95)%, (53.32 ±4.44)% and ( 61.75 + 6.93)%, respectively, with significant difference from the control group (P<0.01). S phase cells in the experimental groups were (25.47±0.74)%, (28.08±1.41)% and (35.49±0.66)%, respectively, with significant difference (P<0.01) from the control group (21.26±0.70)%. Cells in the experimental groups showed nuclear pyknosis, karyorrhexis and poptotic cell morphology. The expression of COX-2 and stathmin in 5-8F cells was down-regulated with increased drug concentration. CONCLUSION Ellagic acid extracted from gallnut has activity against nasopharyngeal carcinoma cells, and its mechanism may be related to down-regulated expression of COX-2 and stathmin.
Antineoplastic Agents, Phytogenic ; pharmacology ; Apoptosis ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cyclooxygenase 2 ; genetics ; metabolism ; Down-Regulation ; drug effects ; Ellagic Acid ; pharmacology ; Humans ; Nasopharyngeal Neoplasms ; pathology ; Plant Extracts ; pharmacology ; Stathmin ; genetics ; metabolism

Objective To explore the subtype,incidence and duration of delirium in intensive care unit(ICU).Methods From October 2015 to September 2017,we prospectively collected baseline information of 516 inpatients met the inclusion criteria of ICU in Jinhua Municipal Central Hospital of Zhejiang Province.We assessed patients with the Confusion Assessment Method for the Intensive Care Unit(CAM-ICU),and analyzed subtype of delirium and compared the incidence and duration of delirium.Results Among 516 patients,there were 119 cases with delirium along with 23.06％for the incidence.There were 14 cases with delirium in the type of increased activities,61 cases with delirium in the type of decreased activities and 44 cases with delirium in the mixed type.Delirium of 79.83％of patients occurred for the first time when being admitted to ICU between the second day and fifth day with 63.87％for the incidence of delirium night.The duration of delirium was from two to three days accounting for 52.94％.There were statistical differences in the occurrence time of delirium with three subtypes(χ2=11.116,P=0.025).The differences in duration of delirium with three subtypes were also significant(H=24.728,P<0.001).Conclusions Patients' high-incidence period of delirium is from the second day to the fifth day after being admitted to ICU.The occurrence time of delirium has the volatility showing the characteristic of light daytime and heavy night.We should strengthen assessment for delirium of patients to identify and take steps early,so as to reduce the occurrence risk of ICU delirium and shorten the duration of delirium.

Objective: To investigate the overexpression frequencies of BRE and EVI1, the correlation between BRE and EVI1 expressions and their possible clinical implications in 11q23/MLL rearrangement acute leukemia. Methods: Cytogenetic examination of bone marrow cells was performed by short-term culture method. R-banding technique was used for karyotype analysis. 47 patients were detected by interphase fluorescence in situ hybridization (FISH) with dual-color break apart MLL probe. The expressions of EVI1 and BRE genes were detected by real time quantitative reverse transcription polymerase chain reaction (RQ-PCR) . The correlation and prognostic significance were statistically tested. Results: 11q23/MLL rearrangements were confirmed by karyotyping and FISH, respectively in 47 patients. According to immunophenotypic analyses of 37 patients, 5 patients showed positive for CD19, CD79a or CD10, 1 for CD7; the others for CD33, CD13, CD14 and CD15, and 16 of them for CD34. Of the 47 patients, 18 patients showed EVI1 overexpression and most of them presented with t (6;11) and M₄/M₅. The EVI1 expression was high in t (6;11) or t (9;11) subgroup comparable with levels observed in normal subgroup (P=0.038, 0.022, respectively) . 15 patients showed high BRE expression, and most of them presented with t (9;11) and M₄/M₅. High BRE expression was found in t (4;11) , t (6;11) , t (9;11) and t (11;19) subgroups, respectively by comparing with normal subgroup. The BRE expression was higher in t (4;11) (P=0.004) or t (9;11) (P=0.012) subgroup than in t (6;11) subgroup. Patients with EVI1 overexpression had a short survival compared with those with low EVI1 expression (P=0.049) and it also did in t (9;11) subgroup (P=0.024) . Patients with t (9;11) and high BRE expression had a long survival compared with those with t (9;11) and low BRE expression (P=0.024) . Conclusion The EVI1 overexpression was significantly frequent in acute leukemia patients with 11q23/MLL rearranged, especially within t (6;11) subgroup and M₄/M₅, which was associated with an inferior outcome. High BRE expression was observed frequently in 11q23/MLL-rearranged acute leukemia especially within t (9;11) subgroup and M₅.

Objectives:To compare the effects of manual and mechanical chest compression on patients receiving extracorporeal cardiopulmonary resuscitation (ECPR).Methods:Patients who underwent extracorporeal cardiopulmonary resuscitation admitted to Jinhua Municipal Central Hospital, Hangzhou First People's Hospital and the First Hospital of Jiaxing from September 2014 to July 2022 were enrolled in the study. The patients were divided into the manual group and mechanical group according to the compression method, and the clinical data of the two groups were compared. To explore the effects of the two compression method on the ECPR implementation, proportion of return of spontaneous circulation (ROSC) and hospital survival.Results:A total of 108 patients who underwent ECPR were included in the study, 50 patients in the manual group and 58 patients in the mechanical group. There were no significant differences in sex, age, laboratory tests before ECPR, ROSC proportion (90.0% vs. 86.2%) and survival (34.0% vs. 39.7%) between the two groups (all P>0.05). The puncture time in the mechanical group was shorter than that in the manual group [12 (9,15) min vs. 13 (11,16) min, P<0.05]. Conclusions:Compared with manual compression, mechanical compression during ECPR neither increase the probability of ROSC nor reduce in-hospital mortality in patients with cardiac arrest. However, mechanical compression may help to shorten the puncture time.

Hepatectomy is the most effective method for the treatment of liver cancer. Asso-ciating liver partition and portal vein ligation for staged hepatectomy (ALPPS) provides resectable opportunities for patients with unresectable or borderline resectable liver cancer. Traditional ALPPS procedures involve a short interval between two stages of the surgery, leading to a higher incidence of perioperative complications and mortality. The authors present a case of two-stage hepatectomy. Initially, laparoscopic ligation of the right hepatic artery and portal vein was performed. To prevent tumor progression after the first stage of surgery, combined immunotherapy and targeted therapy were administered. Three months later, a successful right hemihepatectomy was performed. Postoperative histopathological examination revealed hepatocellular carcinoma with extensive tumor necrosis. A 15-month follow-up showed no tumor recurrence. This indicated that two-stage hepatectomy including simultaneous ligation of the hepatic artery and portal vein, combined with two-stage hepatectomy plus immunotherapy and targeted therapy, showed considerable promise for borderline resectable liver cancer.

Objective To investigate the relationship between urinary polycyclic aromatic hydrocarbon metabolite and cell cycle of lymphocyte in coke oven workers.Methods 437 coke oven workers and 163 workers in water treatment department were recruited in this study.Flow cytometry was used to detect the cell cycle of lymphocyte.For the measurement of urinary metabolites,urine samples were treated with β-glucuronidase and analyzed using HPLC with a fluorescence detector.Results The concentrations of urinary 2-naphthol,2-hydroxyfluorene,9-phenanthrol and 1-hydroxypyrene 1 in coke oven workers were significantly higher than those in control group (P＜0.01).The distributions of cell cycle were analyzed in high exposure group (the content of urinary metabolites high than P75) and low exposure group (the content of urinary metabolites low than P25).According to the content of 1-hydroxypyrene,the proportions of S phase in high exposure group were significantly higher than those of low exposure group (Z=-2.496,P=0.013),but the proportions of G0/G1 phase were significantly lower than low exposure group (Z=-2.074,P=0.038).The similar results were not been found in other hydroxylated metabolites as internal exposure group.Conclusion Increasing levels of urinary 1-hydroxypyrene might resulting in cell cycle of lymphocyte disorders,mainly for G0/G1 phase shorten and S phase arrest.