ObjectiveTo observe the clinical features, complications, and prognosis of subarachnoid hemorrhage (SAH) in the aged. Methods132 old cases were analyzed retrospectively. Results56.8% of patients complained headache as the main symptoms, 43.2% with dizziness or vertigo, 40.1% with disturbance of consciousness, 70.5% with negative of meningeal irritation sign. The most common cause is the aneurysm. The mortality was more in those complicated with hypertension. ConclusionSAH in the old characterized variable clinical manifestations, no special signs, half of them with good prognosis.

Objective To investigate the serum calcium absorption level ,distribution level and nutritional status of 25‐hydroxy vitamin D and parathyroid hormone (PT H ) in pregnant and puerperal women .Methods A total of 740 healthy pregnant women and puerperal women in the perinatal clinic of our hospital from September 2014 to August 2015 were recruited as the observation group and divided into second trimester group ,third trimester group and puerperal group .Contemporaneous 100 healthy non‐preg‐nant women were chosen as the control group .The levels of serum 25‐hydroxy vitamin D and PTH in all research subjects were de‐tected by using the electrochemiluminescence method .Then the differences of detection results were compared among various groups .Results The serum 25‐hydroxy vitamin D level was (57 .9 ± 18 .2)nmol/L in the second trimester group ,(39 .4 ± 15 .0) nmol/L in the third trimester group ,(65 .1 ± 19 .6)nmol/L in the puerperal group and (78 .6 ± 16 .2)nmol/L in the control group , the differences among groups were statistically significant (P<0 .05) .The serum PTH level in the third trimester group was higher than that in the second trimester group ,the difference between the two groups was statistically significant (P<0 .05) .Serum calci‐um ,magnesium and alkaline phosphatase levels in the observation group were lower than those in the control group with statistical‐ly significant (P<0 .05) .Conclusion Pregnant and puerperal women usually have low levels of calcium and magnesium ,and 25‐hy‐droxy vitamin D deficiency .It is necessary to supply vitamin D and other mineral elements when taking calcium supplement .

Objective To investigate the effect of the mild conjunctivitis complication on the tear break-up time(BUT) in pa-tients with dry eye .Methods 93 patients with dry eye from Sep .2007 to Sep .2011 were selected .For all of them the BUT was 5 seconds or less than 5 seconds after corneal fluorescein staining .They were divided into experimental group (with mild conjunctivi-tis) and control group (without mild conjunctivitis) .We checked the BUT and compared the difference of BUT between experimen-tal group and control group .Results The average BUT of the 54 patients with complicated mild conjunctivitis ,of which conjuncti-val papillae was found in 40 cases ,was (3 .54 ± 1 .02)s ,the average BUT of the 39 patients without conjunctivitis was(3 .41 ± 1 .04) s .There was no significant difference between two groups .Conclusion Dry eyes complicated mild conjunctivitis had no effect on BU T .

Objective To report on an autosomal recessive pyramidal tract, corpus callosum and peripheral nerve degeneration in a family and to study its relationship with other complicated hereditary spastic paraparesis. Methods Neurological examination revealed the following findings. Proband was a 20 year old man who spoke slowly and developed mental retardation in his childhood. Gait disturbance with pyramidal signs and mild cerebellar ataxia were found when the patient was 16. Slight sensory disturbance was present in the lower extremities. His 23 year old sister had similar symptoms at beginning of disease when she was 17. Their clinical courses were bad progressively. Electromyogram showed nerve conduction velocity decrease in the nerve medianus and neurogenic process in the muscle tibialis anterior. Cranial MRI, muscle and nerve suralis biopsies were examined in proband patients. Results MRI showed thin corpus callosum with cerebral and cerebellar atrophy as well as enlargement of ventricle system. Myopathological findings were characterized by angular atrophy fibers in small groups with appearance of hypertrophy fibers. The nerve suralis biopsy showed degeneration and regeneration of myelinated axons. Conclusion Our study confirms that this family is hereditary spastic paraparesis with mental retardation, thin corpus callosum and polyneuropathy reported mostly in Japan. Axonal polyneuropathy is a common pathological feature of this disease.

ObjectiveTo investigate prognostic factors in acute exacerbation of COPD (AECOPD).Methods352 AECOPD patients were investigated.26 possible variables were analyzed.Multivariate Logistic and Cox proportional-hazards regression analysis were used.ResultsAccording to multivariate Logistic regression,it showed seven factors were statistically significant for short term prognosis ( P ＜0.05 ),including PaO2 ( OR =0.082),CKMB ( OR =4.967 ),mechanical ventilation ( OR =6.903 ),albumin ( OR =0.221 ),FEV1％ ( OR =0.255 ),charlson index ( OR =8.406 ) and hospital day ( OR =0.075).According to multivariate Cox regression,it showed seven factors were statistically significant for long term survival ( P ＜ 0.05 ) including acute exacerbation frequency( HR =1.611 ),charlson index( HR =4.319),SaO2 ( HR =0.224 ),troponin Ⅰ ( HR =3.824 ),albumin ( HR =0.569 ),hospital day ( HR =0.456) and FEV1％ (HR =0.494).Acute exacerbation frequency was correlated with dyspnea scale( rs =0.508,P ＜ 0.01 ).ConclusionsPaO2,albumin,FEV1％,CKMB and charlson index were related with short term prognosis.SaO2,albumin,FEV1 ％,troponin Ⅰ,charlson index and acute exacerbation frequency were related with long term survival.Higher acute exacerbation frequency contributed to more severe breathing difficulties and worse quality of life.

The purpose of this study was to provide standards for healthy people performance on a Chinese version of the LOTCA.Fifty four the healthy and twenty five CVA patients participated in this study.The study was conducted in three phases.In phase one,the healthy subjects were assessed with the original version of the LOTCA.In phase two,the subjects who had made mistake in recognition of a typewriter for English in the sub test one,the healthy subjects were assessed with the original version of the LOTCA.In phase two,the subjects who had made mistake in recognition of a typewriter for English in the sub test of Categorization or had not known it at all were reassessed by the revised sub test of Categorization.In phase three,the LOTCA was administered to CVA patients.The results show significant differences between the healthy people and CVA patients.The score on the sub test of Categorization of the original version of LOTCA was much less than perfect,however the results of revised Categorization test was consistent with that from Katz et al.The results also show that years of education were related to perceptual cognitive performance.The LOTCA is a feasible and valuable tool,and is recommended for these individuals who has problems with cognition and perception.

Objective To explore the clinical manifestation of stroke caused by central nervous system vasculitis (CNSV). Methods 49 patients who suffered from stroke by CNSV were reviewed retrospectively. Results Among the 49 patients, 5 were intracerebral hemorrhage, 15 were ventricular hemorrhage, 7 were subarachnoid hemorrhage and 22 were cerebral infarction; the mean of age was (26.0±12.7) years old. Conclusion The clinical manifestation of stroke caused by CNSV is variform, and usually happens in young age. CNSV should be considered as the cause of stroke in adolescent.

Objective To investigate the imaging diagnosis and surgical treatment of intestinal malrotation in adult patients. Methods The clinical data of 11 adult patients with intestinal malrotation who had been admitted to General Hospital of PLA from January 2003 to December 2007 were retrospectively analyzed. Multiple imaging modalities, including barium enema, gastrointestinal radiography, B sonography, computed tomography (CT) scan and mesenteric angiography were applied for diagnosis. All patients received Ladd procedure. Results Two patients were diagnosed by gastrointestinal radiography +B sonography, 4 by gastrointestinal radiography +CT scan, 1 by angiography, 1 by B sonography + CT scan, 1 by iodine radiography + CT scan and 2 by intraopera-tive examination. After the operation, 2 had renal insufficiency, 1 had intestinal fistula and 1 had short bowel syndrome and died at the third month after operation. Conclusion Combined application of multiple imaging modalities can improve the diagnostic rate, and Ladd procedure is effective and safe for adult patients with intes-tinal malrotation.

Adult ; Aged ; Arsenic Poisoning ; drug therapy ; etiology ; Drugs, Chinese Herbal ; adverse effects ; Female ; Humans ; Male ; Middle Aged

Objective To summarize the treatment experiences in gastrointestinal leaJcage atter gastrectomy for gastric cancer. Mehods From January 1997 to December 2006 the clinical data of 37 cases of gastrointestinal leakage including anastomotic leakage in 19 cases and duodenal stump leakage in 18 after gastrectomy for gastric cancer in People's Liberation Army General Hospital were analyzed retrospectively. Results All of the Cases were treated with abdominal drainage,continuous gastrointinal decomnression and parenteral nutrition combined with enteral nutrition.There were 32 cases receiving glutamine enrichment nutrition support,31 ases used somatostatin,13 cases received supplemented recombinarlt human growth hormone.Fistula healed in 21～30 d in 9 cases after gastrectomy,in the other 24 cases fistula healed in 30-60 d,while it healed in 60～81 d in the remaining 2 cases.Two died of leakage associated complications after gastrectomy for gastric cancer including anastomotlc leakage follwing esophagojejunostomy complicated by severe thoracic and lung infection in one and duodenal stump leakage complicated by severe abdominal cavity sepsis and hemorrhage in the other. Conclusion Patent and effective abdominal cavity drainage,continuous gastrointestinal decompression,parenteral nutrition combined with enteral nutrition,glutarnine,somatostafin and recombinant human growth hormone are the'mportant factors for the healing of gastrointestinal leakage after gastrectomy tor gastric cancer.