Objective To describe the survival status and to analyze the related factors of mortality among elderly patients with first-ever stroke.Methods Totally 1 96 elderly patients with first-ever stroke from January 2010 to January 2014 were enroll for the study.The survival status of all cases was attained through follow-up,and the deadline of follow-up was July 30,2014.The deceased patients because of stroke were divided into death group while the others were divided into survival group.Univariate com-parison and multivariate Logistic regression analysis were performed to screen out the related factors of death.Results The median follow-up time was 41 months,and 14 cases were lost to follow-up.The survival rate 28 d,1 year and 3 years after the onset were 73.47%,66.81% and 58.89%.Age,complication,Glasgow score,NIHSS score and blood WBC were the independent influence fac-tors of death (P <0.05).Conclusion The death among elderly patients with first-ever stroke are more concentrated in 28 d after the onset.Advanced age,complications,decrease of Glasgow score,increase of NIHSS score and blood WBC could increase the death risk.

Parkinson's disease(PD)is a chronic neurodegenerative disease and commonly seen in middle-aged and elderly people.Combined with age-related loss of bone mass, inadequate intake of vitamin D and calcium due to dysphagia and reduced gastrointestinal motility in the late stages of the disease makes PD patients more susceptible to osteoporosis(OP). Some drugs used to treat PD can also induce and even aggravate osteoporosis in PD patients.Moreover, osteoporosis further impairs mobility in PD patients, causing pain and even fractures.This article reviews the risk factors, pathogenesis, prevention and treatment of PD combined with osteoporosis.

0.05). Compared with the sham operative group, NO content in model group was obviously lower( P

Objective To investigate the clinical epidemiologic characteristics of patients with hepatitis C virus(HCV)infection post blood transfusion.Methods The polymerase chain reaction (PCR)and enzyme linked immunosorbent assay(ELlSA)were used to detect HCV RNA and antiHCV,respectively.Analysis was performed for patients' age distribution,cause of primary diseases,exposure years,ingredient and amount of transfusion,incubation period and liver function damage.The statistical processing were performed with chi-square test,t-test and correlation analysis.Results HCV RNA levels were higher than 3.0 log10 copy/mL in 85.3%infected patients with a median of 5.99log10 copy/mL,among which 19.7%patients showed viral load 3.0 to 4.0 log10 copy/mL and 69.9%showed 5.0 to 6.0 log10 copy/mL.Eighty-one point six percent(40/49)of infected persons were confirmed as HCV RNA positive by HCV RNA qualitative analysis,while 99.7%(383/384)patientswere detected as anti-HCV positive by serological test.The sensitivity of serological test was higher than both HCV RNA quantitative and qualitative assays(F=57.138,P=0.000;F=63.149,P=0.000,respectively).HCV infection post blood transfusion was more common in people of 30 to 60years old.Most cases(84.4%)got the first time exposure during 1990 to 1994.More than 10%cases had primary disease as obstetrics, orthopedics or gastrointestinal tract hemorrhage. Eighty percent received whole blood product transfusion.The mean interval between transfusion and clinical diagnosis was (86.0±54.6 ) months. Eighty nine percent of infected patients had liver function damage, while most of them showed elevated alanine aminotransferase (ALT) with no more than 5 upper limits of normal (ULN). Conclusions Post transfusion HCV infection mainly happened in adulthood. Infected patients usually have liver function damage with elevated ALT with no more than 5 ULN and medium HCV RNA levels.

Objective To analyze the anatomic variation of the portal vein based on magnetic resonance angiography using THRIVE sequence in one-stop examination of the liver.Methods Reconstructed three-dimensional images of 648 cases of hepatic portal vein acquired by THRIVE sequence were analyzed.Anatomic variation of the hepatic portal vein was investigated and the diameters of main portal vein (MPV), splenic vein (SV), superior mesenteric vein (SMV) and inferior mesenteric vein (IMV) were measured.Results (1)Four types of different variations of intrahepatic portal vein were observed, with normal type accounting for 79.2% (514/648), type Ⅰ 8.3% (54/648), type Ⅱ 9.0% (58/648) and type Ⅲ 3.4% (22/648), respectively.(2)Four types of different variations of extrahepatic portal vein were also observed, with type Ⅰ accounting for 37.4% (167/447), type Ⅱ 20.4% (91/447), type Ⅲ 36.2% (162/447) and other 6.0% (27/447), respectively.(3)Diameter of MPV, SV, SMV and IMV were (14.03±2.44) mm, (9.51±2.40) mm, (11.14±1.99) mm and (6.01±0.78) mm, respectively.Conclusion It is feasible to analyze anatomic variation in the hepatic portal vein using reconstructed three-dimensional images acquired by THRIVE sequence in one-stop examination of the liver.

Objective To evaluate the effect of recombinant human erythropoietin (rHuEPO) on lung injury induced by hepatic ischemia-reperfusion (I/R) in rats.Methods Sixty healthy male SpragueDawley rats, aged 6-8 weeks, weighing 220-280 g, were randomly divided into 3 groups (n=20 each) using a random number table: sham operation group (group S) , hepatic I/R group (group I/R), and rHuEPO group (group E).I/R and E groups underwent I/R of 70 percent of the liver.The rHuEPO 4 000 U/kg was injected intraperitoneally at 24 h before I/R in group E, while the equal volume of normal saline was given in S and I/R groups.The rats were sacrificed at 3 h of reperfusion, and lungs were removed and cut into sections which were stained with haematoxylin and eosin and examined under light microscope.Wet to dry lung weight ratio (W/D ratio) was calculated.The expression of heme oxygenase-1 (HO-1) and inducible nitric oxide synthase (iNOS) in lung tissues was determined by immunohistochemistry.The content of malondialdehyde (MDA), and activities of superoxide dismutase (SOD) and myeloperoxidase (MPO) in lung tissues were detected.Results Compared with group S, the W/D ratio, MDA content, and MPO activity were significantly increased, the SOD activity was decreased, the expression of HO-1 and iNOS was up-regulated (P＜0.05) , and the pathological changes of lung tissues were obvious in E and I/R groups.Compared with group I/R, the W/D ratio, MDA content, and MPO activity were significantly decreased, the SOD activity was increased, the expression of HO-1 was up-regulated, the expression of iNOS was down-regulated (P＜0.05) , and the pathological changes of lung tissues were reduced in group E.Conclusion The rHuEPO can alleviate hepatic I/R-induced lung injury in rats, and the mechanism may be related to up-regulated expression of HO-1 and down-regulated expression of iNOS.

Objective To summarize the clinical characteristics , nerve electrophysiological features , imaging manifestations and prognosis of nervous system disorder caused by heat stroke. Methods A retrospective study was un?dertaken on clinical, nerve electrophysiological and imaging characteristics and prognosis of 9 patients who had heat Stroke and received treatment during July and August in 2010 and 2013 at the Second Hospital of Shandong University. Results There were seven males and two females, aged from 47 to 87 years, among 9 patients. All cases are admitted within 6 hours and their Core body temperature were 39.8℃~42.5℃. Patients had disturbance of consciousness and multi?ple organ dysfunction including acute cerebral infarct in 2 cases, peripheral neuropathy in 3 cases, acute respiratory fail?ure in 2 cases, pulmonary infection in 9 cases, disseminated intravascular coagulation in 1 case ,acute myocardial injury in 8 cases, arrhythmia in 3 cases, rhabdomyolysis in 3 cases, acute liver damage in 8 cases, of acute kidney injury in 6 cases, upper gastrointestinal bleeding in 4 cases, metabolic acidosis in 1 case, metabolic alkalosis in 2 cases , electrolyte disorder in 9 cases and quadriplegia in 3 cases. Brain magnetic resonance imaging showed diffuse brain swelling in 6 cas?es and the acute asymmetric lacunar infarction in 2 cases. All patients are treated with cooling , rehydration , anticoagula?tion , reduction of the intracranial pressure and symptomatic treatment. One case died and the condition of remaining cas?es were improved. At one-year follow-up, the symptoms were almost cured in 2 cases, significantly improved in 4 cases with disability degree in grade 1~2, moderately improved in 1 case with disability degree in grade 3, remained unchanged in 1 case with disability degree of grade 5. Conclusion Heat stroke can cause conscious disorder and multiple organ fail?ure .The central nervous system lesions are often presented with diffuse swelling or/and lacunar infarction and presented with peripheral nerve injury in some cases, leaving persistent neurological deficits .

Child ; Humans ; Male ; Muscles ; pathology ; physiopathology ; Myopathies, Structural, Congenital ; diagnosis ; Prognosis

To assess the correlation between thyroid function and glucolipid metabolism in type 1 diabetic adults. A retrospective analysis was conducted in 230 type 1 diabetic adults who were hospitalized in the Department of Endocrinology of Shandong Provincial Hospital Affiliated to Shandong University from January 2008 to January 2020. It showed that thyroid stimulating hormone(TSH) was significantly positively correlated with total cholesterol (TC) ( r=0.239), triglycerides (TG) ( r=0.166) and low-density lipoprotein cholesterol (LDL-C) ( r=0.249), respectively (all P<0.05). Free triiodothyronine (FT 3) was significantly negatively correlated with fasting plasma glucose (FPG) ( r=-0.272), glycated hemoglobin (HbA1c) ( r=-0.240), TC ( r=-0.197) and LDL-C ( r=-0.220), respectively (all P<0.05). Free thyroxine (FT 4) was negatively correlated with TC ( r=-0.171) and LDL-C ( r=-0.170), respectively (all P<0.05). TC was an independent predictor of TSH, FT 3 and FT 4, FT 3 and FT 4 were independent predictors of HbA1c. TSH was an independent predictor of TC, TG and LDL-C. Thyroid function is closely related to glucolipid metabolism in type 1 diabetic adults.

It remains a common problem that the evaluation model of course learning for stu-dents is so simple in the higher education of China. Moreover, the teachers are usually used to evalu-ating student's course learning by summative appraisal and ignore process appraisal, so that the stu-dents are usually lack of learning enthusiasm for self study. Besides, the course learning evaluation of students generally lacks the uniform and detail standard in the country. To resolve these problems, a comprehensive evaluation model of course learning based on the principle of talent evaluation has been practiced and improved since 2007 in some basic medical courses at our university. This model is composed of four parts:the evaluation of mastering basic knowledge, the evaluation of the ability to resolve problems through applied knowledge, the evaluation of practical study and the evaluation of learning initiatives. The model has showed in the practice the characteristics of powerful operability, pluralistic evaluating indicators, combining summative appraisal and process one, reflecting objectively the mastering degree of expertise of students and promoting the self-study of students.