Objective To investigate the depression after stroke in middle-aged patients and discuss the mental nursing.Methods Self-Rating Depression Scale was used to find 30 depression patients from 52 patients with stroke.They were analyzed and accepted mental nursing.Results The rate of depression mental state patients in 52 patients is 57.69%.After accepting mental nursing,the number of unsociability,morose and fatigue decreased,while that of role adaptation and self-confident increased significantly(P<0.05).Conclusion There is high incidence of depression in middle-aged patients with stroke.Mental nursing is helpful improve their adaptation and quality of living.

With the standard of living improved, people had less and less interests in exercise, adiposity has being a problem that people have to be up against all over the world. Exercise can step up energy expenditure, decrease fat accumulation, minish the volume of fat cell, and is one of widely used, effective, safe, economical measures of anti-adiposity. The adaptable change of neuroendocrine system in exercise quicken up fat to burn more. Leptine is an important signal of measuring fat content of body. The relationship between adiposity and leptin, and the effect of exercise on leptin was reviewed in this paper.

Objective To explore the applicability of the abbreviated Chinese version of the social problem-solving inventory (C-SPSI) for nursing students in Shanghai. Methods The abbreviated C-SPSI was revised and 603 nursing students in Shanghai were surveyed by it, and the reliability and con-struct validity were evaluated by inter-item consistency analysis, test-retest reliability and principal factor analysis. Results The total CVI was 0.968. The construct validity was confirmed by factor analysis with 64.917% variance explained by four factors. The total Cronbach's α of C-SPSI was 0.897,and the total test-retest reliability coefficient was 0.781. Conclusions The abbreviated C-SPSI is an instrument with good reliability and validity and it can be used in assessing the nursing students' social problem-solving abilities and deficits.

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.

AIM:To analyze the accuracy and the influencing factors of LAMBDA100 retinometer in predicting the visual acuity of cataract patients with high axial myopia after phacoemulsification.METHODS: The retinal visual acuity was measured in 91 patients with 91 cataract eyes by LAMBDA100, and compared with the best corrected visual acuity 2wk after operations.If differences of predictive visual acuity and postoperative visual acuity between the two logarithmic visual acuity chart was within 2 lines, it was considered consistent.RESULTS: The total compliance rate was 62%, the false positive rate was 2%,the false negative rate was 36%.The predictive accuracy was affected by lens opacity, the deeper opacity, the lower accuracy.The predictive accuracy of eye with axial length ≥32mm was significantly lower than that of eye with axial length <32mm, the difference was statistically significant (P<0.05).The predictive accuracy rate of group that preoperative best corrected visual acuity was ≥4.0 was 75%;the predictive accuracy rate of group that preoperative best corrected visual acuity was <4.0 was 49%, the difference was statistically significant (P<0.05).CONCLUSION: LAMBDA100 can be used as an assistant tool for predicting postoperative visual acuity in immature stage cataract of patients with high myopia.The eye axial length, the degree of visual acuity and lens opacity can influence the predicting accuracy.

Histiocytosis, Langerhans-Cell ; diagnosis ; Humans ; Infant, Newborn ; Male

Objective To investigate the clinical and pathologic features in patients of microscopic polyangiitis (MPA) with peripheral nerve abnormality.Methods We collected clinical data of 6 patients with MPA that was confirmed by immunological,pathological and clinical findings.Electroneurophysiologic examinations and sural nerve biopsies were performed in these patients.Two normal controls were included in these studies.Results All of 6 patients developed asymmetric polyneuropathies.Electrodiagnostic studies showed reduced amplitudes of the sensory nerve action potential and compound motor action potential with mild impaired conductive velocities.The patients presented vasculitis changes with cell infiltration by monocytes and lymphocytes.Sural nerve biopsies found loss of myelinated fibers in all of the patients indicating axonal degeneration.Some of them associated with regeneration clusters of myelinated fibers.Conclusions Asymmetric neuropathy with sensory nerve injuries is the mainfeature in the MPA associated polyneuropathy.Electrodiagnostic examination indicated axonal lesions in mononeuritis multiplex.Sural nerve biopsies confirmed the active axonal lesions and vasculitis.

Objectives To report the clinical and myopathological features in a case with Danon disease caused by a novel mutation in the lysosome-associated membrane protein-2 ( LAMP2 ) B gene.Methods A 16-year-old boy presenting progressive muscle weakness and atrophy, accompanied with spinal ankylosis was clinically evaluated including electrocardiogram, echocardiogram and electromyogram.Muscle biopsy was carried out in the patient.The histological staining, ultrastructural examination, and immunohistochemical staining with antibodies against dystrophin, merosin and C5b9 were performed in frozen sections.LAMP2B sequence was analyzed in the patient and his parents.Results Electrocardiogram in the patient showed Ⅰ atrioventricular block; echocardiogram revealed focal hypertrophy in mitral valve with mild cardiac diastolic dysfunction; electromyogram indicated myogenic and neurogenic patterns.Muscle pathology study revealed numerous vacuoles located at the fibers.Dystrophin, merosin and C5b9 was immuno-positive around the vacuoles.Electron microscopy revealed vacuoles surrounded by sarcolemma and abnormal lysosome aggregating at the fibers.A novel nonsense mutation ( K402X ) in the LAMP2B gene has been identified in the patient but not in his mother and 50 normal controls.Conclusions Danon disease caused by K402X mutation in C-terminus of LAMP2B presented benign course of the disease characterized by prominent vacuolar skeletal myopathy, mild cardiac abnormalities and peripheral neuropathy.

Objective To report filaminopathy with novel insertion mutation in a Chinese family.Methods Total 19 patients from successive 5 generations involved in an autosomal dominant family. The detailed clinical manifestations had been described (Chinese Journal of Neurology, 2008, 41:751-755).The filamin C gene sequencing was performed in 3 patients, 5 family members without symptoms and 50 normal persons. The amplified fragments of the exon 18 in filamin C gene were cloned into pBluesripts vectors, then sequenced and identified with capillary electrophoresis. Results 18-nucleotide deletion and 6-nucleotide insertion were identified in the exon 18 of filamin C gene. The mutation caused the disturbance of the seventh immunoglobulin-like domain in filamin C, leading to the instability of dimmers of filamin C.Another 2 patients in the family had same mutation while 5 family members without symptoms and 50 normal controls were normal. Conclusion The novel nucleotide deletion-insertion in exon 18 of filamin C gene causes filaminopathy. This disease can appear in non-Nordic race.

Objective To report the clinical and pathological features of chronic graft-versus-host disease-related polymyositis by summarizing the clinical data of the patient with chronic graft-versus-host disease-related polymyositis. Methods One patient with chronic graft-versus-host disease-related polymyositis was hospitalized in our hospital on December 29,2010.The patient,40 years old,female,underwent allogeneic haematopoietic stem cell transplantation because of acute granulocytic-monocytic leukemia.Fourteen months later she manifested as slowly progressive muscle weakness and myalgia in all limbs.Serum creatine kinase level was between 426-1948 U/L. Myositis antibody EJ was strongly positive.Electromyogram showed a neurogenic impairment and slow peripheral nerve conduction speed.Muscle biopsies were carried out in the left biceps brechii.In addition of standard histological and enzyme histochemical staining for the muscle sections,immunohistochemical workup was performed with mouse antiCDs,anti-CD20,anti-CD68 and anti major histocompatibility complex- Ⅰ ( MHC- Ⅰ ) monoclonal antibodies as first antibodies.Results The muscle biopsy showed large variation of fiber size,with muscle fiber necrosis,regeneration.Some angular fibers distributed in small cluster.The inflammatory cells infiltrated around the small vessel or in the endomysium,mainly CD8+ T-lymphocytes and CD6+8 macrophages.The most muscle fibers were MHC-Ⅰ positive. Conclusion The graft-versus-host disease-related polymyositis manifests as chronic myositis process with neurogenic lesions.