Objective To explore the clinical significance of mycoplasma pneumoniae(MP) antibody IgM positive with high titers.Methods Two hundred and sixty-seven cases of respiratory tract infections of MP with MP-IgM positive were confirmed in our hospital during Jun.2005 to Aug.2008,of which 63 cases with significantly increased titers of MP-IgM antibodies(MP-IgM≥1:1 280).A prospective observation and later analysis of the clinical manifestations of the 63 cases were carried out.Results 1.Among 63 cases,6 cases were diagnosed as upper respiratory tract infection,12 cases as acute bronchitis and 45 cases as pneumonia,respectively.2.The 63 cases pre-sented mainly with fever and cough,of them 59 cases had fever and 45 cases with paroxysmal cough,39 cases could be found crackles on physical examination.3.Extrapulmonary manifestations could be found in many cases,including heart complications in 21 cases,abnormal liver functions in 35 cases,gastrointestinal manifestations in 22 cases,neurological manifestations in 1 case,dermatological disorders in 7 cases and renal manifestations in 3 cases.4.Patterns of chest X-ray findings of the 63 cases with MP infections were varied,of which 45 cases showed pulmonary abnormality.Chest X-ray findings of the 45 children included 12 cases with interstitial infiltration,6 cases with lobar condensation,15 cases with patch shadows,4 cases with enlarged porta pulmonis and 8 cases with reticulonodular infiltrates.Three cases were complicated with pleural effusion and 2 children with segmental atelectasis.5.The cases were given azithromycin,10 mg/(kg?d),a daily dose for 5 days and intermitted for 4 days.All cases repeated the treatment courses for 1 to 4 times.The mean duration of fever was 6.6 days,cough could last 11.7 days and the crackles on physical examination could not be found 7.5 days later after treatment.The abnormality of chest X-ray findings dissolved in 38 cases 2-3 weeks later after treatment.Conclusions Cases of MP infections with high titers of MP-IgM positive had severe symptoms,of which more than 90% patients presenting with lower respiratory tract infections,mainly with pneumonia.Recovery of chest radiological finding was posterior to clinical improvement,so timely and regular chest X-ray examinations were essential after treatment and could avoid the false ceasing of treatment of the cases.Patients of MP infections with high titers of IgM antibodies positive have good prognosis.

Objective To analyze the trend of disease constitution of hospitalized neonates in China-Japan Friendship Hospital and provide a scientific basis for the focus adjustment of perinatal health.Methods Six hundred and ninety-eight neonates were admitted during Jan.2004 to Dec.2008.Relevant data of all cases were retrospectively collected.The discharge diagnosis of the neonates was counted accor-ding to the year,and the trends of the neonatal disease constitution of the 5 years were analyzed.Results 1.The first 10 diseases of hospita-lized neonates were centralized,and the first 3 diseases including premature infants,neonatal hypoxic-ischemic encephalopathy(HIE) and neonatal hyperbilirubinemia accounted for 42.84% of the neonate diseases.2.The characteristics of neonatal disease constitution were as fo-llows:the disease constitution of premature infants always located within the first 3 diseases;the location of neonatal HIE went ahead from number 8 to number 1 or 2,and its constitution proportion increased from 4.93% to more than 15.00%(P

Objective To investigate the clinical characteristics,pathogen distribution and outcome of lower respiratory tract fungal infection in patients with mechanical ventilation in emergency intensive care unit(EICU). Methods The clinical data of patients with lower respiratory tract fungal infection treated with mechanical ventilation in EICU were retrospectively analysed. Results Eighty(64.5%) of the 124 patients with mechanical ventilation experienced lower respiratory tract infection,among whom 21(26.2%) were complicated with fungal infection.The predominant pathogen was Candida(Candida albicans,n=11;Candida tropicalis,n=5;Candida smooth,n=3;Candida parapsilosis,n=2).Compared with patients with non-fungal infection(n=59),those with fungal infection(n=21) had higher APACHE II score,longer mechanical ventilation time and longer ICU stay duration(P

Objective To explore the proliferation of microglia in the frontal cortex,hippocampus and amygdala of the post-stroke depression (PSD) in rats.To understand the role of microglia in the pathogenesis of PSD.Methods The adult female SD rats were divided into four groups(n=5 per group):normal control group,depression group,stroke group and PSD group.In the depression group,the depression model rat were established by chronic unpredictable mild stress (CUMS) combined with separately breeding.In the stroke group,focal cerebral ischemic rat models were established with thread embolization method.In the PSD group,focal cerebral ischemic models rat were established with thread embolization method firstly,and then PSD models rat were established with comprehensive chronic unpredictable mild stress(CUMS) and separately breeding on this basis.After the procedure,rats were subjected to sucrose preference test and open field test.At the postoperative eighth weekend,immunofluorescence technology was used to detect the proliferation changes of OX42 positive cells in the frontal lobe,hippocampus and amygdale.Results At the 29th day after CUMS,the sucrose solution consumption ((23.8±0.8) ％),horizontal movement distance of open field test ((63.0± 1.2) cm) and vertical movement distance ((25.0± 1.0) cm) in PSD group were significantly lower than those in normal group((31.2± 1.9) ％;(69.8±2.3) cm;(31.0± 1.6) cm) and depression group((31.0±1.4) ％;(70.2±2.4) cm;(30.8± 1.1) cm) (P＜0.05).The number of OX42 positive cells of frontal lobe,hippocampus and amygdale in PSD group((20.8±2.6);(20.2±1.3);(19.8±2.6))increased significantly compared with those of normal group((7.4±2.3);(8.0± 1.6);(9.4±2.1)),depression group((8.0±2.0);(7.8 ±2.2);(9.2±1.9))and stroke group((9.6±1.1);(9.4±2.2);(10.2±2.6)) (all P＜0.05).Conclusion The number of microglia in PSD group in the emotional disorders related brain areas(the frontal lobe,hippocampus and amygdale) increases obviously and the increased expression of microglia in the emotional disorders related brain areas may be responsible for the pathogenesis of PSD.

Objective To explore the expression of the CNPase positive oligodendrocytes in the frontal cortex,hippocampus and amygdala of the post-stroke depression (PSD) model rats,and to understand the role of oligodendrocytes in the pathogenesis of PSD.Methods Healthy adult SD rats were randomly divided into normal group,depression group,stroke group,and PSD group (n =5 in each group).In the stroke group,focal cerebral ischemic rat model was made with thread embolization method.In the depression group,the depression model rats were made by chronic unpredictable mild stress(CUMS) combined with separately breeding.In the PSD group,focal cerebral ischemic rat model was made with thread embolization method firstly,and then PSD rat model was established with comprehensive chronic unpredictable mild stress (CUMS) and separately breeding on this basis.After the procedure,rats were subjected to sucrose preference test (SPT) and open field test (OFT).Immunofluorescence staining was used to detect the expression of the CNPase positive oligodendrocytes in the frontal cortex,hippocampus and amygdala at day 29.Results On the 29th day after CUMS,comparing the sucrose solution consumption,horizontal movement distance of open field test and vertical movement distance of the each group,the depression((26.6± 1.1)％,(63.6±2.3)cm,(26.4±1.1)cm) and the PSD groups((23.8±0.8)％,(63.0± 1.2) cm,(25.0± 1.0) cm) were significantlylower than normal ((31.2± 1.9) ％,(69.8± 2.3) cm,(31.0 ± 1.6) cm) and the stroke groups ((31.0± 1.4) ％,(70.2±2.4) cm,(30.8 ± 1.1) cm) (P＜ 0.05).Comparing the expression of the CNPase positive oligodendrocytes in the frontal cortex,hippocampus and amygdala of the each group,the number of the stroke((16.60± 1.82),(14.60±1.82),(15.00±2.12)),depression((16.40±2.07),(14.80±2.17),(15.80±2.28)) and the PSD groups((12.40± 1.52),(11.20± 1.48),(10.80± 1.92)) were significantly less than that in normal group((20.40±3.51),(18.20±2.59),(19.00±2.55)),and the number of expression CNPase positive oligodendrocytes in the PSD group was significantly less than that in stroke and depression groups(all P＜0.05).Conclusion The number of the CNPase positive oligodendrocytes in PSD group in the emotional disorders related brain areas (the frontal lobe,hippocampus and amygdale) reduced obviously,and the oligodendrocytes may play an important role in the pathogenesis of PSD.

Objective To investigate the expressions of glial fibrilary acidic protein (GFAP) in the prefrontal cortex, hippocampus and amygdala in post-stroke depression (PSD) in rats. Methods Healthy adult SD rats w ere randomly divided into a normal group, a depression group, a stroke group, and a PSD group ( n=5 in each group). A model of focal cerebral ischemia w as induced by the intraluminal suture method in the stroke group;a rat chronic stress depression model was induced by using chronic unpredicted mild stress (CUMS) combined w ith single housing in the depression group;a model of focal cerebral ischemia w as induced by the intraluminal suture method in the PSD group. A rat PSD model w as induced by CUMS and single housing at 1 week after operation. The sucrose preference test (SPT) was performed in each group at day 1, 8, 15, and 29 after the first CUMS, and the open-field test ( OFT ) w as used to evaluate the depressive behaviors. Immunofluorescence staining was used to detect the expression of GFAP in the prefrontal cortex, and hippocampus and amygdala at day 29. Results At day 29 after CUMS, the sucrose solution consumption in SPT and the scores of horizontaland vertical movement in OFT in the depression group and PSD group w ere decreased significantly compared w ith the normal group and the stroke group (al P<0.05);the numbers of GFAP immunopositive cel s in the prefrontal cortex, hippocampus, and amygdala in the PSD group w ere significantly less than those in the normal group, depression group and stroke group (al P<0.05), and there w ere no significant differences among the normal group, depression group and stroke group (al P>0.05). Conclusion The decreased expression of GFAP in the prefrontal cortex, hippocampus, and amygdale may play a certain role in the process of PSD.

Objective To evaluate the vestibular function in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Methods Seventeen CADASIL patients were recruited in the present study and 17 healthy volunteers served as control subjects. Electronystagmogram examinations including gaze nystagmus test, spontaneous nystagmus test, saccade test, pursuit test, optokinetic nystagmus test and caloric test were performed in the subjects. Results Neither patients nor controls had gaze nystagmus or spontaneous nystagmus. There was no difference in the latency and velocity of saccade movement between patients and controls. The accuracy of the saccade movement, the accuracy in leftward saccade, was significantly lower in CADASIL group compared with controls. The pursuit movement gains was also significantly lower in CADASIL group than in control group(G_L:0.79±0.08, G_R:0.76±0.12)(t=-3.739、-2.911,P <0.05) compared with controls(G_L:0.87±0.04, G_R:0.86±0.06).The optokinetic nystagmus gains were significantly decreased in CADASIL group(G_L:0.79±0.17,G_R:0.78±0.18)(t=-2.342、-2.335,P<0.05) compared with controls(G_L:0.90±0.08,G_R:0.89±0.09). The caloric test was performed in one CADASIL patient and the result revealed an incomplete fixing inhibition. CADASIL group was further divided into normal subgroup and abnormal subgroup based on the pursuit curve. The comparison between those two subgroups demonstrated a significant correlation between the pursuit movement and the symptoms of vertigo or dizziness(P<0.05). Conclusions The central vestibular function is impaired in CADASIL patients and the abnormal vestibular function is related to the symptom of vertigo or dizziness in CADASIL patients.

BACKGROUND: Primary progressive aphasia(PPA) is a degenerative disease of nervous system, which is very rare in clinics. Only 3 cases have been reported in our country. There is very little clinical information regarding the characteristics of PPA in linguistics and imageology.OBJECTIVE: To report the language disorder and the characteristics of imageology of one PPA patient for the clarification of the clinical features of PPA.DESIGN: A case analysis.SETTING: Department of Neurology, Beijing Tiantan Hospital; Faculty of Psychology, Beijing Normal University.PATICIPANT: Male, 56 years old, senior high school graduate, businessman before the onset of the disease. The case visited the department of Neurology,Tiantan Hospital, Beijing due to the complaint of three years of progressive decreasing in language skills, which was then diagnosed with PPA.METH ODS: Spoken language fluency evaluation in Chinese Aphasia Examination Set of the First Affiliated Hospital of Beijing Medical University was used to evaluate this patient, the type of Aphasia was judged by Western Aphasia Examination Set, and the severity gradation was classified by the Boston Diagnostic Aphasia Examination(BDAE) . Memory, intelligence screening and imageology examination were performed as well.MAIN OUTCOME MEASURES: The fluency of spoken language, the type of aphasia, and the severity of aphasia of the patient were judged, and whether the patient suffered from memory and intelligence disorder were observed as well as the features of imageology.RESULTS: The patient had fluent spoken language, which was evaluated as sensory aphasia(SA) with the aphasia severity of level 4, and had no memory or intelligence disorder. MRI showed atrophy in left frontal lobe and temporal lobe, which was more significant in left side. MRI also showed that left temporal and frontal lobes had low metabolism and low perfusion.CONCLUSION: PPA is a disease with language disorder as its dominant clinical manifestation, which no other cognitive disorder at its initial stage,and with its main pathological changes in left temporal and frontal lobes.

Acupuncture Analgesia ; Acupuncture Points ; Adult ; Aged ; Aged, 80 and over ; Catheter Ablation ; Female ; Humans ; Liver Neoplasms ; surgery ; Male ; Middle Aged ; Pain Management

0.05).But the amount of adhered bacteria of surface-polished with titanium alloy is greater than that of surface-polished with zirconia ceramics(P