Objective To explore the correlation between heart rate variability ( HRV ) and multiple system atrophy( MSA) .Methods HRV was performed in 34 MSA patients and 32 healthy controls.The parameters of HRV study was compared, parameters studied included time domain and frequency domain.Single factor analysis andreceiver operating characteristic ( ROC ) curves were used to analyze the detection of parameters of HRV. ResultsThe HRV of MSA showed significant decreased from the health controls: root mean square successive difference of intervals (rMSSD) [(51.6 ±29.4)ms vs (70.1 ±34.1)ms,P=0.023],percentage of interval differences of successive N-N intervals greater than 50 ms(pNN50%) [ 4.2% (1.8%,9.5%) vs 9.6%(5.1%, 16.2%),P=0.005], coefficient of variation(CV) [(0.06 ±0.01) vs(0.08 ±0.02),P=0.005],very low frequency(VLF) [1003.4(586.5,1702.9)ms2vs1825.5(1407.2,2670.1)ms2,P=0.000],lowfrequency(LF) [162.9(90.6,337.4) ms2 vs 375.5(210.4,559.5) ms2,P=0.001], high frequency(HF) [164.9(77.5,470.7) ms2 vs 349.1(209.7,738.5)ms2,P=0.005].The areas under ROC in patients with MSA for VLF was 0.703(S=0.053), while the areas for CV, LF, HF and pNN50%were 0.667(S=0.054), 0.660 (S=0.055), 0.650( S=0.055) and 0.640( S=0.055) ,the results all have statistical significance(all P<0.05).The cutoff value of VLF for diagnosing MSA in the early stage was 1240.85, the sensitivity and specificity were 86.7 and 55.4(95%CI:0.599-0.807,P=0.002) .Conclusion MSA has sympathetic and vagus nerve involvement at the early stage disease, resulting dysfunction of cardiovascular autonomic system,VLF may have high drgree of assessing accuracy of its dysfunction.

Electromyography ; Electrophysiology ; Genetic Testing ; Humans ; Neuromuscular Diseases ; diagnosis ; genetics

Abstract? AlM: To observe the effect of combining partial reduction orthokeratology ( Ortho-K ) and spectacles on slowing myopic progressionin high myopic adolescent.? METHODS: Sixty - nine eyes of 36 high myopic adolescent ( aged 9 ~15 years ) with spherical equivalent refraction ≧-6. 00 diopters ( D) ( spherical component≧-5. 50D) were fitted with custom-made four-zone/five-curve Ortho-K lenses. The target of reduction was to achieve -5. 00D for both eyes. The residual refractive errors after at least one month of Ortho-K wear were corrected with single-vision spectacles for clear vision in the daytime. The unaided visual acuity ( UVA) , refractive error ( RE ) , axial length ( AL ) , and ocular health were assessed before the Ortho-K lens wear, and followed up for 2a after Ortho-K.?RESULTS: ( 1 ) Changes in UVA: The mean UVA was 0. 09±0. 05 at baseline before Ortho-K;the mean UVA was 0. 27 ± 0. 14, 0. 54 ± 0. 18, 0. 78 ± 0. 24, and 0. 81 ± 0. 19, respectively after Ortho-K wear for l night, 1wk, 1, and 3mo. The differences of UVA were significant with baseline (P<0. 05), and became stable 1mo after the treatment. (2) Changes in RE:The mean RE was -6. 82± 0. 71D at baseline before Ortho-K and -6. 86 ± 0. 77D after Ortho-K wear for 1a (P>0. 05 compared to baseline). The mean RE was-7. 11±0. 81D after Ortho-K wear for 2a, and the amount of myopia increased -0. 29 ± 0. 37D compared to baseline (P<0. 05). (3) Changes in AL: The mean AL was 26. 18 ± 0. 57mm at baseline before Ortho-K, and it was not significantly different (P>0. 05) from the AL after Ortho-K wear for 6mo (26. 19±0. 54mm) and for 1a (26. 21± 0. 47mm). The AL was 26. 37±0. 59mm after Ortho-K wear for 2a, and the mean increase was 0. 19 ± 0. 28mm compared to baseline (P<0. 05). (4) Grade 1 corneal staining was observed in some subjects at each visit. However, the staining was improved after lens cleaning, discontinuing lens wear, or applying artificial tears. No other adverse events were reported in all subjects during the 2a study.?CONCLUSlON:Combining partial reduction Ortho-K and spectacles completely slowed myopic progression in high myopic adolescent after receiving the treatment for 1a, and partially reduced myopia progression after 2a of treatment. No severe ocular complications were found throughout the treatment. The combination treatment appeared to be effective and safe, but its long-term effect needs to be further assessed.

No abstract available.

Adult ; Cranial Fossa, Middle ; anatomy & histology ; surgery ; Ear, Inner ; anatomy & histology ; surgery ; Facial Nerve ; anatomy & histology ; surgery ; Humans ; Male

Acupuncture ; Animals ; Blood-Brain Barrier ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Medicine, Chinese Traditional ; Rabbits ; Rats ; Research Design

OBJECTIVETo explore the therapeutic efficacy of unilateral multiple channels approach in percutaneous vertebroplasty (PVP) for osteoporotic vertebral fractures.

METHODSA retrospective review (from March 2003 to October 2012) was conducted on 685 consecutive patients, a total of 885 vertebrae were involved. Eighty-two cases (99 vertebrae) with bone cement leakage when less than 0.3 ml bone cement was injected to fill the fracture were given PVP procedure by unilateral multiple channels approach. 38 cases were male (45 vertebrae) and 44 cases were female (54 vertebrae). The average age was 75.4 years old (from 69 to 92). The operation time, amount of injected bone cement and complications were recorded. Rate of excellent and good outcomes was studied by measuring the cement distribution on the X-ray film. The visual analogue scale (VAS) score and Oswestry disability index (ODI) system were used to evaluate the pain relief and improvement of daily activity function respectively at preoperation and 1 hour, 1 month, 3 months and 6 months after operation.

RESULTSAll these ninety-nine vertebrae were treated in 82 cases with PVP of unilateral multiple channels approach. The average operation time was 33 minutes. The rate of excellent and good outcomes of cement distribution was 98.8%. The VAS score was (8.40 +/- 0.73) before surgery,and (2.50 +/- 0.43), (2.00 +/- 0.33), (1.80 +/- 0.28), (2.10 +/- 0.17) at 1 hour, 1 month,3 months and 6 months respectively after operation. ODI was (40.94 +/- 2.72) before surgery, (9.64 +/- 2.60) at 1 month after surgery, (8.52 +/- 2.30) at 3 months after surgery and (7.77 +/- 2.15) at the final follow-up. The differences of the VAS and ODI between pre-operation and post-operation had statistical significance (P<0.01). No spine or nerve injuries occurred intraoperatively.

CONCLUSIONThe unilateral multiple channels approach in percutaneous vertebroplasty can obviously relieve the pain and effectively improve the functional activity, provide a satisfied cement distribution in vertebral body with cement leakage after a small amount infusion.

Aged ; Aged, 80 and over ; Bone Cements ; Female ; Fractures, Compression ; surgery ; Humans ; Male ; Osteoporosis ; surgery ; Retrospective Studies ; Spinal Fractures ; surgery ; Treatment Outcome ; Vertebroplasty

Objective To evaluate the efficacy and safety of the improved percutaneous balloon mitral valvuloplasty (PBMV) in elderly patients with mitral stenosis. Methods Elderly patients with severe mitral stenosis received an improved PBMV which included a modified way of atrial septal puncture and technique across the mitral valve. The left atrial pressrue (LAP), mean pulmonary pressure (MPA), mean gradient across the mitral value (MPG) and mitral valve area (MVA) were recorded and compared before and after the operation. Long term follow up were made. Results After operation, the LAP decreased [(25.3±6.7) mm Hg vs.(16.4±5.8) mm Hg,1 mm Hg=0.133 Kpa], MPG decreased [(17.6±6.7) mm Hg vs.(6.8±2.9) mm Hg], MPA decreased [(38.6±12.1) mm Hg vs. (29.2±9.8) mm Hg], MVA increased [(1.05±0.22)cm2 vs.(1.61±0.38)cm2] and the New York heart association heart function classification improved. The follow-up result showed that the effect of PBMV was constant. Conclusions Improved PBMV may be an effective and safe measure for patients with mitral stenosis.

Objective To investigate the diagnostic value of procalcitonin(PCT)as an early indicator for sepsis.Methods Serum levels of PCT and C-creative protein(CRP)and white blood cell (WBC)count were measured in 30 patients in critical condition hospitalized at an intensive care unit(ICU) with diagnosis of systemic inflammatory response syndrome(SIRS).They were divided into two groups, sepsis and non-sepsis,based on their clinical manifestations and results of lab tests.Blood specimen was collected from each patient for measurement of PCT,CRP and WBC count on the 1~(st),3~(rd)and 7~(th)day after hospitalization and bacteriological culture for blood and sputum,and chest X-ray was performed,as well. Acute physiology,age and chronic health evaluation(APACHE Ⅱ)was made on the 1~(st),3~(rd)and 7~(th)day after hospitalization to assess their ill condition.Their prognosis were judged on the 28~(th)day of the follow-up. Results Serum level of PCT increased significantly in the sepsis group(with the highest of 10.13 ng/ml), as compared with that in the non-sepsis group.Sensitivity,specificity and predictive value of a positive test for a cut-off value of serum level of PCT at 0.5 ng/ml were 97.0%,91.7% and 82.1%,respectively, which were all better than those of serum level of CRP and WBC count.Serum level of PCT in the patients was significantly associated with their prognosis,and PCT in those died was significantly higher than that in those survived.Whereas,serum level of CRP and WBC count elevated in both groups,but the difference between the two groups did not reach a level of statistical significance.Conclusion Serum level of PCT can be used as an early indicator for judgment of sepsis for a patient with infection and reflection of severity of illness.

Objective To analyze the epidemiographic features of malignant tumors of urinary system in renal allograft recipients in our center.Methods A retrospective analysis was performed on 3150 patients who received renal transplantation between June 1978 and Autumn 2006.Twelve cases of urinary tumors were selected for study.Results Among 3150 recipients,33(1.05%)were diag- nosed as malignancies including 12(0.38%)cases in urinary system.The mean age of these patients when diagnosed as urinary tumors was 58.3?4.6(range 48-66).The mean duration of immunosup- pressive treatment was 62?18(range 26-120)months.Six cases received cyclosporine A+azalthio- prine+prednisone(CsA+Aza+Pred),5 cases cyclosporine A+mycophenolate mofetil+prednisone (CsA+MMF+Pred),and one case tacrolimus+mycophenolate mofetil+prednisone(FK506+MMF +Pred).Surgical treatment was carried out in 11 patients.Ten of them were still alive.One case died of cerebral hemorrhage.Conclusions Malignant tumors of urinary system,especially TCC is an im- portant complication in renal transplantation in our center.The occurrence of malignant tumors is inti- mately related to immunosuppressive treatment.The immunological status of patients after renal transplantation should be evaluated in follow-up studies.The treatment consists of complete resection of the mass,decreases of immunosuppressants,chemotherapy or radiotherapy.