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.

Objective: To explore the therapeutic mechanism of Qingnao Yizhi Formula (QYF) for vascular dementia and multi - infarct dermentia. Methods: In- vitro rabbit neuron culture was utilized to investigate the effect of QYF on glutamic - acid - induced neuron injury. Results: QYF could increase the survival rate of iniured neuron(P

Objective To study the small intestinal absorption patterns of glimepiride in rats. Methods A rat model of small intestinal absorption in vivo was employed in this study. The small intestinal absorption rate of glimepiride was detected by high performance liquid chromatography. Results At the low and high concentrations of glimepiride, the average small intestinal absorption rates were 0.233 6 h -1 and 0.217 8 h -1 , respectively. Conclusion The small intestinal absorption pattern of glimepiride might be passive diffusion.

Congresses as Topic ; Humans ; Multiple Myeloma ; United States

Objective:To summarize endoscopic management of cerebrospinal rhinorrhea and position-determining means.Method:Fifteen cases of cerebrospinal rhinorrhea treated by endoscopic approach at our institution were analyzed retrospectively.Aetiology included accidental trauma (10), surgical trauma (4), idiopathic (1). All patients presented with CSF rhinorrhea.Six cases were operated after failure of conservative treatment. Two cases after failure of neurosurgical repair were referred to our department. The largest defect was as big as 2.5 cm×1.5 cm. All patients were scanned by computed tomography and magnetic resonance imaging and confirmed by biochemistry test.Ten patients received high resolution spiral computed tomography bonding ventriculography.Result:We performed intranasal endoscopic repair in all 15 patients. All repairs were successful at the first attempt with a mean follow up of 20 months. One patient had light headache postoperatively and relieved with conservative treatment. All defects of skull base detected by computed tomography and ventriculography were confirmed in the operation.Conclusion:Intranasal endoscopic repair of cerebrospinal rhinorrhea can be an effective method. High resolution spiral computed tomography scan combined with ventriculography is a precise position-determining means. With the advancement of instrument and operative skill,the scope of endoscopic repair will further extend.

Objective To summarize the successful experience of radiodiagnosis specialist nursing model in our hospital.Methods Retrospectively analyze the course of establishment and development of radiodiagnosis specialist nursing model in our hospital.Many aspects including setting of the nursing unit,post,quota and salary,development of post responsibilities,systems,standards and procedures,establishment of quality control and performance evaluation system,standardization of the conventional specialist technology,study and application of the new specialist technology were expounded.Results Radiodiagnosis specialist nursing model had been established and improved after five years' exploration.Quality index of care,service and safety showed a steady upward trend.Specialist new technologies had prominent features.Teaching and research achieved initial success.Conclusions Establishment of radiodiagnosis specialist nursing model makes radiology nursing connotation more comprehensive.More importantly,it is of significance in guiding the development of radiodiagnosis specialist nursing.

Objective To summarize the clinical effects of one stop hybrid approach for treating the tetralogy of fallot complicated with aorta pulmonary collateral arteries. Methods From Janu 2008 to June 2013, 79 cases of tetralogy of fallot were complicated with aorta pulmonary collateral arteries with mean age (5.4±3.9) years and weight (18.2±5.7) kg. All patients were diagnosed by echocardiography examination and accepted 64-row CT for demonstration of no dysplasia in pulmonary ressels, McGoon index was (1.7±0.6) and Nakata index was (176.7±7.3). 76 cases had aorta pulmonary collateral arteries for preliminary screening, and accepted cardiovascular angiography before operation. 3 cases were misdiagnosed before surgery and were confirmed by cardiovascular angiography after operation. Results There were 4 deceased cases with an operative mortality of 5.1%. 1 case died of lung infection and 3 cases died of refractory heart failure. In all aorta pulmonary collateral arteries, the smallest diameter was 2.5 mm, the largest was 9.4 mm, average (5.3±2.1) mm. 2 to 21 coils were implanted in respective case with an average of 10.2 coils per case. The maximum number of coils implanted in 1 single ressel was 9. The average number of ressels occluded was 3.7 (range from 1 to 11 ressels) in each case. One case received second closure due to re-open of collateral arteries on neo-vasculanigation. 14 cases had lung infection and 3 cases had pulmonary edema post operation. 75 cases were followed up for 3-72 months. 4 cases with post operative heart function of NYHA gradeⅢtoⅣand all other cases with gradeⅡon higher. Conclusions Peri-operative hybrid management for aorta-pulmonary collateral arteries can increase the operative success rates and reduce complications.

Objective:To observe therapeutic effect of ambrisentan on Eisenmenger syndrome (ES) .Methods:A total of 79 ES patients ,who hospitalized in Wuhan Asia Heart Hospital from Apr 2011 to Mar 2014 ,were divided into ambrisentan group (n=38 ,received digoxin combined ambrisentan treatment) and routine treatment group (n=41 , received digoxin treatment) ,and both groups were treated for 12 weeks .The 6min walking distance (6MWD) , WHO functional class (WHO FC) of pulmonary hypertension etc .were observed in both groups before and 12-week after treatment .Changes of hemodynamic parameters ,including mean pulmonary artery pressure (mPAP) ,total pulmonary resistance (TPR) and ratio of pulmonary circulating flow to system circulating flow (Qp/Qs) etc .,were observed in ambrisentan group before and after treatment . Results:Compared with before treatment , after 12 weeks ,6MWD significantly rose ,TPR significantly reduced ,Qp/Qs significantly increased and WHO FC signifi-cantly improved in ambrisentan group ,P<0.05 or <0.01. Compared with routine treatment group after 12 weeks , there was significant rise in 6MWD [ (356.8 ± 74.1) m vs .(393.7 ± 69.2) m] ,significant reduction in BNP level [(832.5 ± 422.2) ng/L vs .(646.6 ± 297.1) ng/L] and significant improvement in WHO FC (class I/II ,67.5% vs . 86.8% ) in ambrisentan group ,P<0.05 or <0.01. No patient died ,the adverse reactions were mild in ambrisentan group ;one case died in routine treatment group .Conclusion:Oral ambrisentan can significantly improve heart func-tion and exercise capacity in patients with Eisenmenger syndrome ,and it possesses good safety and tolerance .

Objective To evaluate the diagnostic value of serum M-type phospholipase A2 receptor(PLA2R) antibody detection for the diagnosis of idiopathic membranous nephropathy(IMN) by meta analysis.Methods By searching the databases of PubMed,Emabse,Wanfang and CNKI from inception to May,2017,all the literatures referred to serum PLA2R antibody for the diagnosis of IMN in both English and Chinese were reviewed and selected according to the inclusion and exclusion criteria.QUADAS was used to assess the quality of eligible studies.Meta-disc 1.4 was used to analyze heterogeneity and pooled effectsize and Stata 12.0 was used to analyze publication bias.Results A total of 20 studies with high quality were included.Heterogeneity test indicated there was no threshold effect.The pooled sensitivity was 0.69 (95 ％ CI:0.67 to 0.72),the pooled specificity was 0.97 (95 ％ CI:0.96 to 0.98) and the summary area under curve was 0.880.Sensitivity analysis indicated that the result was stable.Deek's funnel plot indicated there was no publication bias.Conclusion The sensitivity of detection of serum PLA2R antibody was acceptable for the diagnosis of IMN with high specificity,so more attention on PLA2R antibody should be paid in the clinical practice.