Objective To study the clinical and neuroimaging features of subtypes of multiple system atrophy (MSA) and their correlations. Methods One hundred and forty-three MSA cases fulfilled Gilman diagnostic criteria (1999) were recruited and their clinical subtypes and stages were classified. Using the staging methods of the pontine cross sign and putaminal slit proposed by Horimoto, 108 patients showed abnormalities in MRI and were further evaluated. The relationship between the subtypes of MSA, disease duration, and MRI abnormalities has been analyzed. Results Of 143 MSA patients, the male-to-female ratio is 1.3:1 ; 93 cases are diagnosed with MSA-C, 39 with MSA-P, and 11 with MSA-P + C; 90 cases with probable diagnosis, and 53 with possible diagnosis. Of the 76 MSA-C cases with MRI abnormalities, 36 (47%) show the pontine cross sign and 10 (13%) show the putaminal slit; of the 24 MSA-P cases with MRI abnormalities, 6 (25%) show the pontine cross sign and 6 (25%) show theputaminal slit. In addition, MSA-C cases with shorter disease duration demonstrate earlier stages of the pontine cross sign. Conclusions In this study, the number of MSA-C cases is more than MSA-P, which might be related to the ethnic background. In neuroimaging, both the pontine cross sign and the putaminal slit are the marked features of MSA. To some degree, the subtypes of MSA are related with the features of imaging, that is, MSA-C patients present the pontine cross sign more often than MSA-P, and the putaminal slit is a comparatively common feature among MSA-P cases.

Objective To study the correlation between clinical rating scale and the duration of multiple system atrophy.Methods One hundred and twenty-two MSA cases fulfilling Gilman diagnostic criteria were recruited.Unified Multiple System Atrophy Rating Scale(UMSARS)was applied to assess the degree of the patients' disability.For analyzing the correlation between the UMSARS scores and the duration of the disease,the Spearman's rank correlation coefficients were calculated.Results Among 122 MSA cases,male:female ratio was 1.7:1;disease duration lasted(2.8±1.6)years:possible MSA accounted for 50 cases(41%),probable MSA 72 cases(59%);MSA-P 35 cases(29%);MSA-C 73 cases(60%).MSA-P+C 5 cases(4%),MSA-A 9 cases(7%).The scores of UMSARS,UMSARS-Ⅰ and UMSARS-Ⅱ were found positively correlating with the disease duration.The Spearman's rank correlation coefficients were 0.368,0.266 and 0.392 respectively,all P<0.01;the adjusted Spearman's rank correlation coefficients were 0.360,0.257 and 0.385 respectively.all P<0.01.Conclusions MSA has complex clinical manifestations.which should include MSA-P+C subtype.UMSARS is a reliable scale to mirror the progression of MSA.which is useful to study the clinical features and disease duration of MSA.

Objective To investigate the characteristics of PMP22 duplication mutation and the clinical variability of Charcot-Marie-Tooth disease type 1A (CMT1A) patients. Methods PMP22 duplication mutation analysis were performed in 45 cases diagnosed probably CMT by combination of improved allele-specific PCR-restriction enzyme digestion and short tandem repeat (STR) analysis based on laser-induced fluorescence detection in capillary electrophoresis. The clinical features of the positive cases were precisely analyzed. Results With the combined use of two methods, PMP22 duplication was detected in 21 cases, i.e. 10 CMT1 cases with typical presentations including weakness and atrophy in the distal limbs, and 11 atypical cases with special phenotypes including 1 case with mild dizziness, 1 case with hearing loss, 2 cases with recurrent limbs weakness, 2 cases with postural tremor in the upper limbs, 4 cases with cerebellar ataxia and 1 case with epilepsy. Conclusions The improved allele-specific PCR-restriction enzyme digestion provides the accurate, reliable and feasible method to detect PMP22 duplication, which is the most common cause of CMT. Comprehensive analysis of clinical, electrophysiological and pathological features of the CMT1A patients with positive PMP22 duplication indicate the high clinical variability of this disease.

Objective To investigate the incidence and influencing factors of depression in empty-nest elderly, so as to provide evidence for reducing depression in empty-nest elderly. Methods During July to August 2016, the elderly over 60 years old in Shaanxi Province, including 504 empty-nest elderly and 194 non-empty-nest, were selected convenience sampling method. The Geriatric Depression Scale (GDS), Social Support Scale, and self-designed questionnaire about the general condition were used. ANOVA was applied to analyze the depression scores; Pearson correlation analysis was used to analyze the relation between social support and depressive symptoms; and Logistic regression analysis had been used to analyze the influencing factors of depression. Results The detection rate on depression of empty-nest elderly was 45.63%, and that of the non-empty-nest elderly was 32.99%, the difference was statistically significant (χ2=10.447,P< 0.05). The scores of GDS of the empty-nest and non-empty-nest elderly were (9.68±5.26) and (8.51±4.69) respectively, and the difference was statistically significant (t=7.390,P< 0.01). Logistic regression analysis showed that living pattern (OR=0.596), degree of education (OR=0.799), age (OR=1.394), place of abode (OR=1.699), happiness degree of later life (OR=1.663) and current life satisfaction (OR=1.474) were correlated with depressive symptom (P<0.05). In addition, Pearson correlation analysis indicated that the social support of the empty-nesters was negatively correlated with depression (r=-0.260,P<0.01). Conclusions The incidence of depression is high in empty-nest elderly, which seriously affects the physical and mental health of them. Targeted measures should be taken to provide more comprehensive social support for empty-nest elderly, improve their life quality and reduce the incidence of depression.

Objective To evaluate the efficacy of auricular-plaster therapy indiabetes patients with insomnia, and provide suggestions for treatment.Methods The relevant randomized controlled trials and quasi-randomized controlled trials about using auricular-plaster therapy in diabetes patients with insomnia were searched in Cochrane Library, JBI, EMbase, Chinese Biological Medical Database ( CBM ) , Wanfang Data, VIP, China National Knowledge Internet(CNKI) and Pub Med. Information was selected. Retrieval time was limited from the foundation of those database to January 1st 2016. We use the Review manager 5. 3 analysis software to conduct Meta-analysis.Results 10 primary studies were included, which involved in 1 315 patients. Meta-analysis was processed based on different intervention methods and various outcome indicators. ①Different intervention methods:the effective rate of the auricular-plaster therapy group were higher than the control group, with significant differences [ OR= 7. 56, 95%CI ( 3. 92, 14. 58 ) , P<0. 000 01 ]; The effective rate of the comprehensive group ( including auricular-plaster therapy) were higher than the control group, with significant differences [OR=3.45, 95%CI(2.60,4.57), P=0.009];②Different results of outcome indicators, comprehensive interventionhas significant improvementonthe sleep quality of patients [MD=-1.96,95%CI(-2.33,-1.59),P<0.000 01];Moreover, comprehensive intervention could control postprandial blood glucose within twohours,with significant differences [MD=-1.86,95%CI(-1.94,-1.78),P<0.000 01].Conclusions Theauricular-plaster therapy can improve the sleep quality and sleep effect of diabetes patients with insomnia. However, because of the large literature difference, the results of the meta-analysis should be critical treated.

Objective To make volunteer service for the aged of university students as an important complement for the aged care to establish a long-term mechanism of volunteer service for the aged. Methods The teaching model integrated volunteer service for the aged into nursing practice teaching was built by adding practice of community volunteer service for the aged to the courses of community nursing. Results This research structured the organization and management model in volunteer service for the aged nursing practice teaching and preliminarily created an appraisal and motivation mechanism through setting up rules and regulations, evaluation for service effects as well as excitation mechanism. Conclusions We found a teaching model integrated with nursing practice teaching and volunteer service for the aged as well as an approach to attain a long-term and persistent development of volunteer service for the aged so as to provide a practical and theoretical basis basis for a long-term development volunteer service for the aged of university students.