Humans ; Minimally Invasive Surgical Procedures ; adverse effects ; methods

Objective To explore the early clinical characteristics of multiple system atrophy (MSA) in the elderly,and provide the basis for early diagnosis.Methods Totally 102 cases with probable MSA in elderly patients were retrospectively analyzed to understand the beginning symptom,clinical features and assistant examination results,combined with the literature review.Results Among the 102 cases diagnosed as probable MSA (61 cases were male and 41 cases were female),57cases (55.9％) were diagnosed as parkinsonism dominant MSA (MSA-P) subtype and 45 cases (44.1％) as cerebellar dominant MSA (MSA-C)subtype.In the beginning symptom,27 cases appeared autonomic dysfunction,including 15 cases (26.3％) in MSA P subtype and 12 cases (26.6％) MSA-C subtype; 14 cases manifested as dysuresia,11 cases as orthostatic hypotension,and 8 cases as sexual dysfunction.Parkinsonism as the beginning symptom was in 49 cases,among whom 24 cases were of abnormal gait,3 cases of resting tremor,16 cases of muscle rigidity,and 15 cases of slowed movement.Cerebellar symptoms as the beginning symptom were in 33 cases,with gait and limb ataxia of 27 cases,dysarthria of 6 cases,nystagmus of 2 cases.Pyramidal tract signs as the beginning symptom were in 2 cases.There was early misdiagnosis of 36 cases (35.3％).Conclusions As wide variety of early clinical features,MSA can be easily misdiagnosed.The clinical features and assistant examination should be paid attention to improvement of the accuracy of early diagnosis.

Designer Drugs ; Drug Design ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Tablets

AIM: To investigate the change of estrogen receptor (ER) in hippocampus, hypothalamus and pituitary of female rats exposed to psychological stress, and to illuminate the mechanism of dysfunction on ovarian reproductive endocrine function. METHODS: Sound, light and electricity were combined into a psychological stressful stimulus to induce female rat dysfunction on ovarian reproductive endocrine function. Immunohistochemical technique and image analysis were used to assess the expression levels of ER in hippocampus, hypothalamus and pituitary. RESULTS: When exposed to compound stressful stimulus of sound, light and electricity for 20 days in female rats, the expression levels of ER in hippocampus, hypothalamus and pituitary dropped. CONCLUSION: The decrease in estrogen receptor expression in hippocampus, hypothalamus and pituitary of female rats exposed to psychological stress may be one of the mechanisms of ovarian reproductive endocrine dysfunction.

Objective To investigate and dispose an outbreak of seasonal influenza in hospital,so as to provide reference for the prevention and control of influenza outbreak in hospital.Methods Eight cases of influenza-like in-fection occurred in the department of neurosurgery at a hospital between July 29 and August 7,2014,epidemiologi-cal investigation was conducted,throat swabs of infected persons were collected for laboratory detection.Results Of 8 infected persons,6 were health care workers (HCWs)in department of neurosurgery,1 was a family member of HCW,and 1 was a patient,the major symptoms of the infected persons were low-grade fever,sore throat,and ma-laise,there were 67 patients and HCWs in this department,the attack rate of influenza was 11.94%,there was no similar infection in other departments of the hospital during the same period.The throat swabs from 6 infected HCWs were positive in influenza virus nucleic acid detection.Office for healthcare-associated infection (HAI)man-agement participated the investigation,after active isolation and antiviral treatment,the outbreak was effectively controlled.Conclusion This HAI outbreak is a seasonal influenza H3 outbreak,ventilation and environmental dis-infection in wards should be strengthened when central air conditioning is running,anti-influenza vaccination among HCWs should be performed during the epidemic season of influenza,and surveillance should be strengthened to pre-vent influenza outbreak in hospital.

More attentions have been paid to the development of evidence-based clinical practice guidelines (ECPGs) of Chinese medicine (CM). International guideline evaluation instruments such as Appraisal of Guidelines for Research and Evaluation (AGREE I) has been gradually applied in ECPGs quality evaluation of CM. Nowadays, there are some certain methodological defects in partial ECPGs of Chinese medicine, with relatively low applicability and slowly update. It is suggested to establish technical specifications of CM-ECPGs in accordance with the characteristics of CM and international general specification, strengthen the quality evaluation of CM-ECPGs, attach great importance to the regularly update as well as popularization and application of CM-ECPGs.
Evidence-Based Medicine ; Humans ; Medicine, Chinese Traditional ; Practice Guidelines as Topic

We detected the seroprevalence of Toxoplasma gondii (T.gondii) in the wild birds in northeast China.The wild bird's blood was collected from the cutaneous ulnar vein and the serum was isolated and used for detection of anti T.gondii antibody by modified agglutination test (MAT).Results showed that totally 179 birds' serum samples were collected.Twenty serum samples (11.17％) were positive with T.gondii antibody,which belonged to 9 orders,17 families and 31 species.The seroprevalence against T.gondii was about 5.26％ (1/19) in Columbiformes,9.09％ (9/99) in Passeriformes,14.29％ (3/21) in Falconiformes,15.00％ (5/22) in Piciformes,16.67％ (1/6) in Coraciiformes,and 25.00％ (1/4) in Anseriformes.Based on their feeding behavior,the seroprevalence was 12.00％ (3/25) in carnivorous wild birds,10.60％ (15/141) in omnivorous wild birds,and 15.38％ (2/13) in the wild birds feeding on aquatic animals or plants.These wild birds also can be sorted as migratory and sedentary (non-migratory) according to their migration habits,and the serum positivity was 11.67％ (14/120),and 10.71％ (6/59) respectively.The seroprevalence against Toxoplasma gondii in wild birds in northeast China is about 11.17％,which indicates a common infection of Toxoplasma gondii in wild birds.

Background Combination of cataractopiesis with intraocular lens (IOL) is believed to improve the patient' s quality of life. However, 1OL power and axial length measured by traditional method in silicone-filled eye is normally bias to the actual levels. The optical coherence biometry technology has been widely used in the measurement of IOL, but little studies have been conducted to demonstrate the IOL power difference between those methods. Objective This study was to evaluate the predictability of IOL power calculations using the IOLMaster and adjusting contact ultrasound A-scan method in silicone oil-filled eyes. Methods Forty-four silicone-filled eyes of 42 patients were divided into 2 groups according to the intraocular pressure (IOP) ( group A: ≥ 10 mmHg group,29 eyes;group B:＜10 mmHg group, 15 eyes). IOLMaster and ocular ultrasonic measurement were used to measure the axis length before and after silicone oil was removed. The preoperatively measured eye axis and cornea curve were used to calculate the theoretical IOL. Results In normal IOP group ( T≥ 10 mmHg,29 eyes), the precision and stability of IOLMaster for axial length ( AL ) measurements and IOL power calculations were better than adjusted ultrasound A-scan( ZIOLMasterdependent = -2. 236, P = 0. 025 ), although in low IOP group ( T＜ 10 mmHg, 15 eyes),there were too much differences in axial length mesurement and IOL power calculation between the IOLMaster and adjusted ultrasound A-scan, so the post-operative imformation was not predicted accurately. Conclusion For anticipatory normal postoperative IOP eyes, the refractive outcome in cataract surgery in silicone oil-filled eyes can be predicted reliably and accurately with IOLMaster. But for complicated or anticipatory unstable postoperative IOP eyes,secondary implantation of IOL would be better.

Objectives: The survivors of first-ever stroke are at a high risk of recurrent stroke. The time interval between first-ever stroke and first recurrence of stroke, however, have not been well studied. The aim of the present study was to evaluate the time interval between first-ever and first recurrence of stroke and the risk factors of stroke that were related to the length of time interval. Methods: Patients admitted in our hospitals during 2014 with first recurrence of stroke were included in the study. A total of 377 patients were enrolled and a standardized questionnaire was used to collect data in this retrospective study. Results: The mean time interval among all the subjects was 58.42 months (median, 36.01 months; range 0.16months to 455.98months). The mean time interval was shorter in hemorrhagic stroke group (56.78 months) than in ischemic stroke group (58.75 months), but the difference was not significant (p=0.819). The median of time interval was similar in the two groups. The associated risk factors to the length of time interval were age over 60 years, subtype of first-ever stroke, the length of history of hypertension. Age was the only associated risk factor to the time interval among patients with first recurrence of hemorrhagic stroke. Conclusion: Factors associated with the time interval are different among different types of recurrent stroke. This provides the basis for preventive treatment for recurrent stroke after their first-ever stroke
Stroke

Animals ; Arteriovenous Malformations ; complications ; Child, Preschool ; Diaphragm ; blood supply ; Hemothorax ; etiology ; Humans ; Male ; Nematode Infections ; pathology ; Pleural Effusion ; etiology