Objective To investigate the risk factors of restless leg syndrome (RLS) among male elders.Methods A case-control study between 148 old male RLS patients (case group) and 155 non-RLS male elders (control group) was conducted to investigate the risk factors of RLS.The general demographic data (age,education level,marital status,etc.),lifestyle (including physical exercise,smoking and alcohol) and past medical history were compared between two groups.Univariate analysis and non-conditional multivariate Logistic regression analysis was conducted by SPSS 13.0 software.Results In univariate analysis:there was significant difference in history of Parkinson disease between two groups [8.8％ (13/148)vs.3.2％ (5/155)] (P ＜0.05),but there was no significant difference in smoking,alcohol,physical exercise,history of diabetes mellitus and history of peripheral nerve disease between two groups (P ＞ 0.05).The serum creatinine in case group was higher than that in control group [(103.92 ± 32.07) μ mol/L vs.(85.35 ± 36.14) μ tmol/L] (P =0.000),and there was no significant difference in systolic blood pressure,diastolic blood pressure,hemoglobin,fasting blood glucose between two groups (P ＞ 0.05).Multivariate analysis showed that after adjusting for potential confounders,history of Parkinson disease and peripheral nerve disease,and serum creatinine was the independent risk factors of RLS among male elders.The values of OR(95％ CI) were 5.68(1.046-30.846),4.13(1.109-15.368),1.02(1.014-1.036),respectively.Conclusion Histories of Parkinson disease and peripheral nerve disease and serum creatinine are the independent risk factors of RLS among male elders.

Objectives To investigate the clinical feature of Parkinson's disease (PD) with restless leg syndrome (RLS) and the pathogenesis of RLS. Methods We conducted a cross-sectional and control study. The case group concluded 31 PD with RLS patients, meanwhile 39 PD patients were selected as the control group. Clinical history, clinical manifestations, complications and laboratory examinations were compared respectively between the two groups. Results All the RLS symptoms did not appear in RLS patients until the PD symptoms came out. Significant differences were found in complications such as swallow disturbance, constipation and illusion, when we compared the two PD groups (P ＜ 0.05 ). Compared with the PD or healthy group, the level of serum ferritin and the H-reflex latency of tibial nerve were significantly decreased in PD with RLS group ( P＜0.05). Conclusions Secondary RLS is a complication of PD.Deficiency of iron and decreased inhibition function of spinal cord may lead to the occurrence of RLS in PD patients. When their motor symptoms are serious and complications are more common, PD patients are more possible to have RLS symptoms.

ObjectiveTo assess the value of the area of ground glass opacities (GGOs) in lungs displayed by high-resolution computed tomography (HRCT) in paraquat (PQ) poisoned patients in evaluating prognosis. Methods Clinical and imaging data of 137 patients with acute PQ poisoning admitted to Affiliated Hospital of the Medical College of Chinese People's Armed Police Forces from January 2012 to August 2014 were analyzed retrospectively. The plasma concentration of PQ on admission and the area of GGOs were compared between two groups. The lung HRCT within 10 days of poisoning was performed every 3 days, and the areas of GGOs were evaluated on five levels, including aortic arch, aortic pulmonary window, left upper lobe bronchial, right inferior pulmonary vein, and left diaphragmatic dome. Receiver operating characteristic curve (ROC) was plotted to evaluate the value of all the parameters for prognosis.Results Among 137 patients, 45 died within 28 days after poisoning, with the mortality rate of 32.85%. The plasma PQ level in the non-survivors was significantly higher than that in the survivors (mg/L:7.06±0.67 vs. 3.51±0.34,t = 5.280,P = 0.000). The areas of GGOs at three time points in the non-survivors were significantly higher than those in the survivors [1-3 days: (32.0±5.0)% vs. (2.5±0.4)%,t = 7.860,P = 0.000;4-6 days: (45.5±5.7)% vs. (2.8±0.5)%,t = 12.420,P = 0.000; 7-10 days: (68.0±4.8)% vs. (3.0±0.6)%, t = 23.950,P = 0.000]. ROC analysis demonstrated that the area under the ROC curve (AUC) of GGOs in 7-10 days was 1.000, which could be used to determine the prognosis, but it was too late for the treatment. The AUC of GGOs in 4-6 days was 0.979, with the threshold of> 12.0%, the specificity of 96.15%, the sensitivity of 85.19%, the positive predictive value of 88.46%, and the negative predictive value of 94.94%, which presented good effect in predicting prognosis in the early stage of acute PQ intoxication. But plasma PQ concentration was relatively poor for determining prognosis, AUC was 0.821, with the threshold of> 1.95 mg/L, the specificity of 34.52%, the sensitivity of 88.64%, the positive predictive value of 41.49%, and the negative predictive value of 85.29%.Conclusions The area of GGOs displayed by HRCT can be used to evaluate the fully developed acute PQ lung injury, and it is superior to plasma PQ concentration. The area of GGOs displayed by HRCT 4-6 days after intoxication can be used for the evaluation of PQ induced pulmonary injury in the early stage and the evaluation of clinical prognosis.

OBJECTIVE To discuss the role of head hygiene for nosocomial infection control in operating room.METHODS The head band was weared to improve head hygiene,and enhance the consciousness in control nosocomial infection.RESULTS From Mar 2004 to Mar 2006 there were 2534 cases operated and 23 cases suffered incision infection(0.91%) when surgeon was without use of head band;but from Mar 2004 to Mar 2006 there were 3014 cases operated and the incision infection rate was 0.40%(12 cases) when surgeon was with use of head band.It was an effective method for reducing sweat-inducing contamination by wearing head band to control nosocomial infection in operating room.CONCLUSIONS To improve the head hygiene by wearing head band is arelatively simple practice,it can control nosocomial infection in operating room.

OBJECTIVE:To observe the efficacy and safety of oxaliplatin,mitomycin and doxorubicin combined with three-di-mensional conformal radiotherapy for patients with lack of blood supply hepatocellular carcinoma. METHODS:62 patients with lack of blood supply hepatocellular carcinoma who lose the opportunity of operation were randomly divided into control group(31 cas-es)and observation group(31 cases). Control group received puncture through the femoral artery by Seldiner,selectively interven-ing in hepatic arteries for DSA angiography,then intravenously injected 130 mg/m2 Oxaliplatin for injection via the catheter,once every 2 weeks+Mitomycin for injection 10 mg,intravenously,once every 1-3 week(s)+Doxorubicin for injection 1.2 mg/kg,once every 3 weeks,then giving Iodinated oil emulsifier and Gelatin sponge particle for hepatic artery embolization,appropriate Iodinat-ed oil emulsifier and Gelatin sponge particle once a month,for 3 times. Observation group was additionally received three-dimen-sional conformal radiotherapy 2 Gy,for 25-30 times with total dose of 50-60 Gy,once every 3 days. They were treated for 3-month. Clinical efficacy,the survival rate and median survival time after the first administration of drug for 1,2 and 3 years in 2 groups were observed,and the incidence of adverse reactions was recorded. RESULTS:The total effective rate,the survival rate and median survival time in 1,2 and 3 years in observation were significantly higher than control group,with statistical signifi-cance (P<0.05). The incidences of neutropenia,thrombocytopenia,hemoglobin decreased and radioactive disease in observation group were significantly higher than control group,with statistical significances(P<0.05). CONCLUSIONS:Oxaliplatin,mitomy-cin and doxorubicin combined with three-dimensional conformal radiotherapy have good efficacy for patients with hepatocellular lack of blood supply carcinoma,also can prolong the survival time,they show poor safety.

White matter hyperintensities (WMHs) is a magnetic resonance imaging phenotype of cerebral small vessel disease,which is manifested as diffuse or confluent subcortical white matter.There is usually no clinical manifestation in the early stage of WMHs,and its pathophysiological mechanism has not been fully elucidated.Studies have shown that a variety of factors are associated with WMHs.The article reviews the risk factors for WMHs.

The clinical data and imaging findings of 10 patients with reversible splenial lesion syndrome ( RESLES ) admitted in Shanxi people′s Hospital from August 2014 to August 2016 were retrospectively analyzed .All 10 patients were acute or subacute onset , the etiology included viral meningitis ( n =5 ) , purulent meningitis ( n =2 ) , tuberculous meningitis ( n =1 ); and one schizophrenic patient receiving antipsychotic drug and one epileptic patient treated with phenytoin .There were 8 patients under 30 years.The clinical manifestations included headache , fever, disorder of consciousness and mental symptoms.Seven patients had prodromic infections before the onset of the disease and focal neurological defects were present in the early stage .The initial MRI showed isolated splenium of corpus callosum (SCC) lesions with homogeneous hyperintense on T 2WI, hypointense on T1WI, and patchy, round, ovoid, schistose diffusion with hyperintense on DWI in all 10 cases;and there was no significant strengthening on enhanced MRI in 4 cases.The follow-up MRI showed that SCC abnormalities disappeared after treatment in 9 cases and the neurological symptoms disappeared after one-month follow up in 6 cases.The results indicate that RESLES is frequently secondary to infections , and presents the symptoms of mild encephalitis or encephalopathy .

Stroke is one of the main causes of adult disability and death, and ischemic stroke is the most common type of stroke. Therefore, it is of great significance to evaluate the condition and outcome of patients with ischemic stroke timely and accurately. As a cheap, non-invasive and multi-functional technology, electroencephalogram (EEG) can directly reflect the abnormal state of brain function and metabolism, and is more sensitive to brain damage caused by the decreased cerebral blood flow. It has important significance in predicting the outcome of patients with ischemic stroke. This article reviews the changes of EEG after ischemic stroke and the characteristic EEG changes related to the outcome of ischemic stroke.

Objective To evaluate the treatment of posterior malleolar two-part fractures complicated with medial and lateral malleolar fractures via a combination of posterolateral and posteromedial approaches.Methods From January 2014 to January 2017,26 patients were operatively treated at Department of Orthopaedics,Tongji Hospital for posterior malleolar two-part fractures complicated with medial and lateral malleolar fractures via a combination of posterolateral and posteromedial approaches.They were 10 men and 16 women,aged from 53 to 67 years(average,61.5 years).The surgery was conducted in prone position via the posterolateral and posteromedial approaches to expose simultaneously the fractures ends at medial,lateral and posterior malleoli for open reduction.The lateral malleolar fractures were fixated with plate,the medial malleolar fractures with screws and posterior malleolar fractures with plate or cannulated screws depending on the size of the fracture blocks.The outcomes were assessed using the ankle-hindfoot scores of American Orthopaedic Foot and Ankle Society(AOFAS) and the visual analogue scale(VAS).Results Of this cohort,22 were followed up for 30 months on average(range,from 18 to 48 months).All the cases healed by the first intension without any infection.Their postoperative X-ray showed bone union after an average of 12.5 weeks(range,from 10 to 15 weeks).No nonunion,loosening or breakage of implants was found.The mean time for walking with full weight-bearing was 13 weeks(range,from 11 to 16 weeks).Their AOFAS ankle-hindfoot scores at the final follow-ups were 85.4(range,from 80 to 92),yielding 13 excellent and 9 good cases with a good to excellent rate of 100%.Their mean VAS scores were decreased significantly from preoperative 8.6±0.6 to postoperative 1.7±0.3(f=153.000,P=0.000).Conclusion In treatment of posterior malleolar two-part fractures complicated with medial and lateral malleolar fractures,a combination of posterolateral and posteromedial approaches in prone position can expose and reduce simultaneously the fractures ends at medial,lateral and posterior malleoli,leading to satisfactory clinical outcomes.

BACKGROUND/AIMS: This study was designed to investigate the effect of Fengliao-Changweikang (FLCWK) in diarrhea-predominant irritable bowel syndrome (IBS-D) rats and explore its underlying mechanisms. METHODS: IBS-D model rats were induced by neonatal maternal separation (NMS) combined with restraint stress (RS). In in vivo experiments, the model rats were randomly divided into 5 groups: NMS + RS, FLCWK (low dose, middle dose, and high dose), and pinaverium bromide. The normal control (no handling) rats were classified as the NH group. The therapeutic effect of FLCWK was evaluated by fecal characteristics, electromyographic response and abdominal withdrawal reflex scores. In in vitro experiments, the model rats were randomly divided into 2 groups: NMS + RS, FLCWK (middle dose), and no handling rats were used as the NH group. The differences in basic tension and ACh-induced tension of isolated colonic longitudinal smooth muscle strips (CLSMs) among the 3 groups were observed. In addition, different inhibitors (nifedipine, TMB-8, L-NAME, methylene blue, and 4-AP) were pretreated to explore the underlying mechanisms. RESULTS: In in vivo experiments, fecal characteristics, electromyographic response, and abdominal withdrawal reflex scores significantly improved in the FLCWK group, compared with the NMS + RS group. In in vitro experiments, the basic tension and ACh-induced tension of CLSMs in IBS-D rats were significantly inhibited by FLCWK. After pre-treatment with different inhibitors, the ACh-induced tension of CLSMs in each group showed no significant difference. CONCLUSIONS: FLCWK manifested curative effect in IBS-D rats by inhibiting colonic contraction. The underlying mechanisms may be related to regulatory pathway of nitric oxide/cGMP/Ca2+ and specific potassium channels.
Animals ; Colon ; Gastrointestinal Motility ; Herbal Medicine ; In Vitro Techniques ; Irritable Bowel Syndrome ; Methylene Blue ; Muscle, Smooth ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Potassium Channels ; Rats ; Reflex