Objective To investigate the sleep architecture in dementia with Lewy bodies (DLB),and study the sleep architecture and cognitive functions in DLB.Methods We described polysomnography (PSG) findings in 34 consecutive subjects diagnosed with DLB.All the patients underwent Mini-Mental State Examination (MMSE),Montreal Cognitive Assessment (MoCA),Clinical Dementia Rating (CDR) to quantify cognitive functions.Results (1)Sleep architecture analysis:DLB group compared to normal control group,the sleep period time (SPT) was reduced (P ＜ 0.05),total sleep time (TST) and sleep efficiency (SE) were decreased,total wake time (TWT) and wake after sleep onset (WASO) were increased,1 non-rapid eye movement (NREM) sleep (TS1),2NREM sleep (TS2),total NREM sleep (TNREMS),and REM sleep (TREMS) time were significantly decreased (P ＜0.01).(2)The DLB patients were divided into groups based on MMSE,MoCA,qnd CDR scores,the sleep architecture of each group was no significant difference (P ＞ 0.05).Conclusions Patients with DLB exists sleep architecture disorder.The cognitive functions and sleep architecture changes in patients with DLB have no obvious correlation.It is different from other degenerative dementia.

Objective To study the epidemiological and clinical features of primary hyperthyroidism complicated with thyroid cancer.Methods Clinical data of 30 cases of hyperthyroidism complicated with thyroid cancer(hyperparathyroidism group)were retrospectively analyzed.They were chosen from the 365 cases of primary hyperparathyroidism treated by operation from Jan.2002 to Jun.2011.At the same time,30 cases of thyroid cancer without hyperparathyroidism were randomly taken out as the control group.Results The incidence of thyroid cancer in primary hyperparathyroidism was 8.22％ (30/365).The median course,preoperative diagnostic rate of thyroid cancer,and lymph nodes metastasis rate for hyperparathyroidism group and control group was 875.00 vs 120.00 days(z =-2.501,P ＜0.05),40.0％ (12/30) vs 66.7％ (20/30) (x2 =4.286,P ＜0.05),and 20.0％ (6/30) vs 46.7％ (14/30) (x2 =4.800,P ＜ 0.05) respectively.All patients were followed up with the average of 4.5 years,ranging from 1 month to 9 yeas and a half.1 case(3.3％)in hyperparathyroidism group recurred hyperthyroidism 5 years after surgery.1 case(3.3％)recurred thyroid cancer 1 year after surgery and received operation again,and 1 case(3.3％)died half a year after operation from respiratory failure caused by lung metastasis of thyroid cancer in the control group.Conclusions Hyperthyroidism complicated with thyroid cancer has the characteristics of high incidence rate of thyroid cancer in the hyperthyroidism patients,long course,high preoperative misdiagnosis rate,low lymph node metastasis rate,favorable prognosis and so on.

Objective To investigate the effect of electroacupuncture at different points on auditory brainstem response (ABR) in a rat model of sodium salicylate-induced tinnitus.Method Forty-one male Wistar rats were randomly allocated to saline control (saline), sodium salicylate model (SA), electroacupuncture at Tinggong+ Yifeng (EA), electroacupuncture at Waiguan+ Zhongzhu (AA) and electroacupuncture at Zusanli+ Sanyinjiao (LA) groups. The saline group consisted of five rats and each of the other groups, nine rats. The model was made by intraperitoneal injection of sodium salicylate 275 mg/kg. The saline control group was injected with a corresponding volume of saline. Various acupoint electroacupuncture groups were given electroacupuncture at bilateral Tinggong+ Yifeng, Waiguan+ Zhongzhu and Zusanli+ Sanyinjiao, respectively, at 30 min after model making. Electroacupuncture lasted 30 min. The ABRs were recorded before model making and once every one hour for five consecutive hours after model making. The stimulus sounds were short clicks and tone bursts of frequencies of 4, 8, 16 and 32 kHz. The ABR threshold was used as an assessment index.Results Under the condition of clicks, there was a statistically significant difference in the ABR threshold at one to five hours after model making between the SA, EA, AA or LA group and the saline group (P<0.05), at two to five hours after model making between the EA or AA group and the SA group (P<0.05) and at one hour after model making between the LA and SA groups (P<0.05). Under the conditions of 4, 8 and 16 kHz, there was a statistically significant difference in the ABR threshold at one to five hours after model making between the SA, EA, AA or LA group and the saline group (P<0.05). Under the condition of 32 kHz, there was a statistically significant difference in the ABR threshold at one to five hours after model making between the SA, AA or LA group and the saline group (P<0.05). Under the condition of 4 kHz, there was a statistically significant difference in the ABR threshold at two to five hours after model making between the EA and SA groups (P<0.05) and at four to five hours after model making between the AA and SA groups (P<0.05). Under the condition of 8 kHz, there was a statistically significant difference in the ABR threshold at two to five hours after model making between the EA or AA group and the SA group (P<0.05). Under the condition of 16 kHz, there was a statistically significant difference in the ABR threshold at two, four and five hours after model making between the EA and SA groups (P<0.05). Under the condition of 32 kHz, there was a statistically significant difference in the ABR threshold at one to five hours after model making between the EA and SA groups (P<0.05).Conclusion Electroacupuncture at both periauricular and forelimb points can improve the ABR threshold in sodium salicylate-treated rats. The effect of electroacupuncture at periauricular points is superior to that at forelimb points.

OBJECTIVETo optimize the method in the Chinese Pharmacopoeia for determining Salviae Miltiorrhizae Radix et Rhizoma.

METHODTanshinone II(A) and salvianolic acid B were selected as the index in optimization of the sample preparation method of Salviae Miltiorrhizae Radix et Rhizoma in Chinese Pharmacopoeia. Orthogonal test was used to optimize the extraction process of Salviae Miltiorrhizae Radix et Rhizoma, and concentration of contents were detected by high performance liquid chromatography method. A detection of using methanol-water (85: 15) at wavelength of 270 nm was employed for tanshinone II(A) and a detection of using methanol-acetonitrile-formic acid-water (30:10:1: 59) at wavelength of 286 nm was employed for salvianolic acid B.

RESULTThe optimized extraction process of tanshinone II(A) and salvianolic acid B was: extracted by 90% methanol and reflux twice (0.5 h each time) at 75 degrees C, extracted by 70% methanol and reflux twice (1.5 h each time) at 75 degrees C, respectively.

CONCLUSIONOptimized extraction and determination methods could be used to reflect the content of tanshinone II(A) and salvianolic acid B in Salviae Miltiorrhizae Radix et Rhizoma more accurately and efficiently.

Benzofurans ; analysis ; Chromatography, High Pressure Liquid ; Diterpenes, Abietane ; analysis ; Rhizome ; chemistry ; Salvia miltiorrhiza ; chemistry ; Temperature

OBJECTIVETo evaluate the accuracy and safety of pedicle screw insertion with the aid of novel patient-specific drill-guide templates in scoliosis cases.

METHODSTen patients with scoliosis were selected to participate in the research (the observation group) from December 2013 to December 2014. The data was obtained from CT scanning, and put into the computer to perform reconstruction of spine, simulation of pedicle screw insertion, and design of patient-specific drill-guide templates with software. The templates were made with rapid prototyping technique. After sterilization, the templates were used to aid the pedicle screw insertion intraoperatively. The blood loss, operation duration, change of creatinine level pre- and post-operation, and complications related to pedicle screw insertion were recorded. The location of pedicle screws were graded so as to evaluate the accuracy. A comparative study was then performed with the data of ten scoliosis cases operated with free-hand method during the same period (control group). There were 5 cases of idiopathic scoliosis and 5 cases of congenital scoliosis in the observation group, including 3 males and 7 females. Their average age was 11.9 years old (ranged, 4 to 18 years old), and the average Cobb angle of main curve was 54.9° (ranged, 42.1° to 78.4°). There were also 5 cases of idiopathic scoliosis and 5 cases of congenital scoliosis in the control group,including 2 males and 8 females. Their average age was 12.6 years old (ranged, 6 to 17 years old), and the average Cobb angle of main curve was 56.6° (ranged, 38.2° to 93.4°).

RESULTSA total of 167 pedicle screws were inserted intraoperatively, with 138 screws (82.6%) in grade I, 26 screws (15.0%) in grade II, 4 screws in grade III (2.4%), but no screws in grade IV according to the CT image. There were 29 (17.4%) screws perforated, and 163 (97.6%) screws could be accepted. In the control group, a total of 165 pedicle screws were inserted intraoperatively, with 98 screws (59.4%) in grade I, 39 screws (23.6%) in grade II, 21 screws in grade III (12.7%), and 7 screws in grade IV (4.2%). There were 67 (40.6%) screws perforated, and 137 (83.0%) screws could be accepted. The grade distribution of screw position, ratio of perforated and accepted screws were significantly different between the two groups respectively (Z=-5.013, P=0.000; χ2=9.347, P=0.002; χ2=20.242, P=0.000). The correction rate of Cobb angle were (74.1±10.0)% vs (69.7±17.6)%; blood loss were (455±447) ml vs (415±389) ml; operation duration were (163.5±53.7) min vs (164.0±48.7) min; and the changes of creatinine level pre- and post-operatively were (-5.3±3.2) μmol/L vs (-3.4±3.1) μmol/L; all above data had no significant differences respectively (t=0.696, P=0.496; t=0.214, P=0.833; t=0.022, P=0.983; t=1.375, P=0.192). There were no complications related to pedicle screw insertion in each group.

CONCLUSIONThe novel patient-specific drill guide template can be used to assist the insertion of pedicle screws in scoliosis cases with much higher accuracy than that of freehand method and fair safety.

Adolescent ; Case-Control Studies ; Child ; Child, Preschool ; Female ; Humans ; Male ; Pedicle Screws ; Scoliosis ; surgery ; Tomography, X-Ray Computed

Medical whole-body positron emission tomography (PET), one of the most successful molecular imaging technologies, has been widely used in the fields of cancer diagnosis, cardiovascular disease diagnosis and cranial nerve study. But, on the other hand, the sensitivity, spatial resolution and signal-noise-ratio of the commercial medical whole-body PET systems still have some shortcomings and a great room for improvement. The sensitivity, spatial resolution and signal-noise-ratio of PET system are largely affected by the performances of the scintillators and the photo detectors. The design of a PET system is usually a trade-off in cost and performance. A better image quality can be achieved by optimizing and balancing the key components which affect the system performance the most without dramatically increases in cost. With the development of the scintillator, photo-detector and high speed electronic system, the performance of medical whole-body PET system would be dramatically improved. In this paper, we report current progresses and discuss future directions of the developments of technologies in medical whole-body PET system.
Humans ; Positron-Emission Tomography ; trends

BACKGROUND: As a micro-injurying and reduplicative treatment of osteoarthritis,the arthroscopic debridement has got the affirmation of numerous scholars. But as one of the standard procedures in artnroscopic debridement,synovectomy is called in question recently.OBJECTIVE: To explore the applied value of synovectomy in the arthroscopic debridement of osteoarthritis.DESIGN: Retrospective controlled analysis.SETTING: Department of Orthopaedics, Fushun Central Hospital.PARTICIPANTS: Sixty-five patients received synovectomy in the arthroscopic debridement of knee joint osteoarthritis in the Department of Orthopaedics,Fushun Central Hospital from February 1997 to December 2000.Thirty-two among them,with complete data and over 1 year's followup,were taken for synovectomy group. Forty-eight patients received the arthroscopic debridement of knee joint osteoarthritis without synovectomy in the Department of Orthopaedics,Fushun Central Hospital from January 2001 to November 2003.Thirty among them,with complete data and over 1 year's follow-up,were taken for control group.METHODS: Synovectomy was taken as the factor of intervention in the operation to perform grouping. The analysis of curative effect was performed to control with joint douching,corpus liberum removal,osteophyma cleaning,meniscus fitting,cartilage gouging,synovectomy and without synovectomy or part synovectomy. Lysholm evaluation standard of knee joint osteoarthritis was used to the knee joint functional evaluation beween preoperation and postoperative 1 year in two groups. And operative time,postoperative draining quantity,postoperative 7-day visual analog score,postoperative 1-year Lysholm score of knee joint, were recorded.MAIN OUTCOME MEASURES: Preoperative and postoperative 1-year Lysholm score of knee joint,operative time,postoperative draining quantity,postoperative 7-day visual analog score.RESULTS: Sixty-two patients were included and all of them entered the result analysis.The preoperative patients in two groups were comparable with each other and the differences of Lysholm score were not significant (t=0.127,P=0.899).The operative time was longer in synovectomy group than in control group,the differences were significant (t=9.547,P ＜ 0.001)and the postoperative draining quantity was more in synovectomy group.The postoperative visual analog score was bigger in synovectomy group than in control group and the differences were significant [the scores of synovectomy and control groups were respectively (4.6±1.1),(2.8±1.4),t=6.206,P ＜ 0.001].The differences of knee joint score in 1-year follow-up were not significant [the scores of synovectomy and control groups were respectively (77.6±11.9),(79.0± 10.3),t=0.562,P=0.576].CONCLUSION: Synovectomy can not increase the curative effect in the near future in the arthroscopic debridement of osteoarthritis. On the contrary,the operative time was longer,the operative wound was larger and postoperative reaction was more serious. It should not be used in the debridement generally.

Objective To investigate the effects of contrast dose and region of interest (ROI) depth on quantitative analysis of liver by contrast-enhanced ultrasound (CEUS) during clinical application.Methods After bolus injection of contrast agent,the change of quantitative parameters [including echo mean(EM),rise time(RT),peak intensity(PI),mean transit time(MTT),area under the curve(AUC),time from peak to one half(TPH),wash in slope(WIS),time to peak(TTP)] of time-intensity curves were analyzed based on groups from different doses (1.0 ml and 1.6 ml) and different depth (＜30 mm,30-60 mm,and ≥60 mm).Results MTT and TPH were increased with dose increasing from 1.0 ml to 1.6 ml (P＜0.05).With the dose 1.0 ml,TPH,WIS,PI,AUC and MTT showed significant difference when the depth of the ROI changes (P ＜0.05),with the depth increased,TPH,WIS,PI,and AUC all decreases and MTT increases.For all the other parameters,no significant changes were found (P ＞0.05).Conclusions CEUS and its imaging process can directly influence the accuracy of the parameters from the quantitative analysis.Standardization of contrast agent with predefined dose and depth can potentially facilitate future clinical studies in liver CEUS.

[Summary] A 32 year-old woman in the third trimester of pregnancy was admitted for severe acute pancreatitis due to hypertriglyceridemia . During hospitalization she developed multiorgan dysfunction , infected pancreatic necrosis , abdominal compartment syndrome and intrauterine fetal death . She was successfully treated by multidisciplinary team including department of emergency medicine , ICU, gastroenterology, obstetrics, endocrinology, ultrasonography, radiology, infectious disease, nutrition and surgery.

Objective To explore the relationship between Wuyishan cliff tea and esophageal cancer,and make integrated measures to prevent and control esophageal cancer.Methods A case-control study was conducted with a ratio of 1 to 1 and a health survey was conducted on objects which included 92 cases with histologically confirmed diagnoses of squamous-cell carcinoma of the esophagus and 92 controls matched by age,sex and resident.The analysis method of conditional logistic regression was used to analyze the influence of cliff tea on the development of esophageal cancer. Results The frequency of cliff tea drinking was 73.91% in cases with esophageal cancer compared with 84.78% in controls. As compared with subjects without tea drinking,subjects with cliff tea drinking significantly decreased the risk for developing esophageal cancer (P<0.05),and its OR were 0.60.The risk of esophageal cancer significantly reduced with increasing frequency of cliff tea drinking per week. Furthermore, we also found that the risk of esophageal cancer significantly reduced with the duration of cliff tea drinking and the early of beginning to drink cliff tea.Conclusion Wuyishan cliff tea drinking may protect against the risk of esophageal cancer.