Objective To discuss the clinical features and related factors of psychosis in patients with Parkinson's disease (PD) and assess the prevalence of psychosis.Methods A total of 82 patients with Parkinson's disease and 69 healthy controls were evaluated by Brief Psychiatric Rating Scale and neuropsychiatric questionnaire.For the PD group,the age at PD onset,type and dose of PD medications,and rapid eye movement (REM) sleep behavior disorder (RBD) were recorded.Unified Parkinson's disease rating scale (UPDRS,parts Ⅱ and Ⅲ) and Hoehn-Yahr staging were used for the evaluation of the severity of motor dysfunction,Hamilton depression scale (HAMD) for emotional state,montreal cognitive assessment (MoCA) for cognition,and scales for outcomes in Parkinson's disease-SLEEP (SCOPA-SLEEP) for quality of sleep.Results The prevalence of psychosis was 36.59％ in PD patients and 2.90％ in the control group.The difference between the two groups was statistically significant (P＜ 0.001).Among the 30 PD patients with PD psychosis meeting the NINDS/NIMH criteria,patients experienced illusions,false sense of presence,hallucinations and delusions was 22.0％,14.6％,29.3％,and 7.3％,respectively.Univariate analysis showed that age,levodopa equivalent dosage,SCOPA-SLEEP scores,and prevalence of RBD were significantly higher in thePDP group [(71.1±6.18),(628.7±283.2),(15.3±7.28),60.00％] than in the PDNP group [(66.6±9.25),(461.1±317.2),(9.7±7.64),28.85％] (all P＜0.05).Multivariate analysis showed that Hoehn-Yahr staging was a protective factor (OR =0.039,95％ CI:0.004-0.402),while sleep disorder was a risk factor (OR=1.157,95％CI:1.015-1.320).The PD patients with more psychotic symptoms were much older and with higher SCOPA-SLEEP scores,which had a statistically significant difference (P =0.0042,P =0.0112).Conclusions The prevalence of psychosis is much higher in PD patients than in healthy controls.PD psychosis is correlated with older age,larger levodopa equivalent doses,higher SCOPA-SLEEP scores,and prevalence of REM sleep behavior disorder.

Objective To explore the clinical and imaging features of primary lateral sclerosis(PLS).Methods The clinical and imaging data of 3 patients with PLS were analysed.Results 3 patients included 2 females and 1 male.The onset of the disease was insidious.The initial symptoms included rigidity and weakness of right upper limb(case 1),rigidity and weakness of legs(case 2),and pseudobulbar palsy(case 3). As the disease progressed slowly,the patients presented with spastic paralysis of four extremities,reduced muscle strength(3 to 4 degree),clasp-knife like of muscular tension,hyperactivity of tendon reflexes,ankle clonus and presence of Babinski sign.In T2-weighted images of the brain MRI,the abnormal high signals were symmetrically situated in the motor cortex,the posterior limbs of internal capsules,cerebral peduncles and basilar part of pons.1H magnetic resonance spectroscopy(1HMRS) showed decreases of N-acetylasartate(NAA) and the ratio of N-acetylaspartate/Creatine(NAA/Cr) in the focal regions.Conclusion PLS presents with characteristic features of clinical symptoms,signs and abnormal changes of MRI.In addition,1HMRS may be helpful in diagnosis of this disease.

Objective To analyze effect of oxycodone hydrochloride injection preemptive analgesia on serum cellular immune factors and analgesic effect in postoperative patients with humeral fracture surgery.Methods 52 patients treated by surgical treatment of humeral fractures in our hospital were collected.All patients were randomly divided into experimental group and control group,26 cases in each group.Preemptive analgesia drugs were given corresponding, before and 24h after surgery, the serum levels of interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), venous blood CD4 +T, CD8 +T cells and CD4 +/CD8 + T levels and analgesic effect were detected in all patients.Results After surgery, compared with control group, the serum levels of TNF-αand IL-6 were lower in experimental group (P<0.05); the venous blood CD4 +T cell and CD4 +/CD8 + T levels were higher(P<0.05), CD8 +T cell level was lower in experimental group (P<0.05);the visual analogue scale(VAS) score was significantly lower in 2,4,6,12 and 24h after surgery in experimental group (P<0.05).Conclusions The oxycodone hydrochloride injection preemptive analgesia can significantly inhibit the increase of the serum TNF-αand IL-6 levels, prevent the decrease of immune function, improve the analgesic effect.

Objective To study the MRI findings of HE and the pathological mechanism and to improve the diagnosis and differential diagnosis of HE. Methods Five patients of HE diagnosed by clinical and laboratory examination were examined with conventional MRI scan. Additional DWI, MRA and enhancement MRI scan were performed on 3 patients in which abnormal findings was detected on the conventional MRI. The distribution of lesions and signal characteristics were analyzed. The ADC values of the lesions and of the contralateral non-lesion area were measured. Moreover, the possible pathological mechanisms of HE were discussed on the basis of changes of clinical and imaging manifestations in the two cases with serial clinical and MRI data. Results Of 5 patients, brain abnormalities were found in 3 cases,which showed scattered spotted supratentorial white matter lesions of isointensity on T1 WI and DWI, and high signal intensity on T2WI and fluid-attenuated inversion recovery (FLAIR). Meanwhile, multiple plaque-like lesions involving both white matter and gray matter were found, mainly located at the basal ganglia nuclei, hippocampus and cingulate cortex. The lesions demonstrated iso-or hypo-intensity on T1 WI,and iso-or hyper-intensity on T2 WI, FIAIR and DWI at the initial stage. No enhancement was found in these lesions and MRA disclosed no remarkable findings. The ADC value of the lesions [ (0. 449 ± 0. 092) ×10-3 mm2/s] was decreased significantly compared with the contralateral noninvolved area [ (0. 838 ±0. 062) × 10-3 mm2/s] at the early onset. In 2 cases with glucocorticoid therapy, together with symptom relief, MRI follow-up scan demonstrated the reduction of lesion volume, the signal change to hyperintensity on T1 WI and hypo-intensity on DWL The ADC of the lesions increased significantly. Conclusion The MRI could be one of the effective tools for diagnosis, differential diagnosis, and judging the prognosis and therapeutic results of HE. Meanwhile, it may be a non-invasive method to study the pathological mechanism of HE.

Objective To discuss perioperative features, operative approach and surgical effects of spinal tuberculosis in older patients. Methods Retrospective analysis was conducted to analyze the clinical data of 45 patients with spinal tuberculosis ranging in age from 61 to 78 years (average, 67 years). The lesion was located in thoracic vertebrae in 9 patients, thoracolumbar vertebrae in 14, lumbar in 16, and lumbosacral in 6. Preoperative Frankel grades were B in 7 cases, C in 21, D in 11 and E in 6. Among them, 21 had cardio-cerebrovascular disease, 10 had diabetes mellitus. With preoperative medicine and chemotherapy for 2-3 weeks, all patients were treated surgically. The surgical procedures included: 1) Posterior focus debridement, bone grafting and one-stage posterior transpedicular screw system fixation in thoracic vertebrae (T2-T7). 2) Anterior debridement, bone grafting and one-stage posterior transpedicular instrumental fixation in lumbosacral vertebrae (L5-S1). 3) Anterior focus elimination, bone grafting and one-stage anterior plate fixation in the other vertebrae. Results Forty-five patients were followed up for 24 to 40 months, with the average of 28.5 months. No severe complication occurred during and after operation. Forty-four cases had recovered and 1 recurred. Spinal fusion occurred 12-18 months after operation. Frankel neurological grades improved significantly. Conclusion With the effective management of comorbidities in perioperative period,the elderly could tolerate surgical treatment. The appropriate approaches, thorough debridement and reasonable bone grafting with internal fixation are key to therapeutic success.

Animals ; Cardiovascular Diseases ; genetics ; pathology ; Cell Proliferation ; Genes ; Microfilament Proteins ; genetics ; Muscle Proteins ; genetics ; Muscle, Smooth, Vascular ; pathology ; Rats

Objective To study and evaluate islet cell adenoma of preliminary diagnosis.Method Retrospective analysis Wag done on 22 patients clinical data of preliminarily diagnosed islet cell adenoma.They were divided into two groups according to final diagnosis,group of islet cell adenoma(n=16)and group of reacfional hypoglycemia n=6).Results There were significant differences between the two groups in term of fames,cold sweat,cataphora,Whipple triad,hungry test,the ratio offasting blood insulin and fasting blood glucose exceeding 0.3 (I/G＞0.3) (P＜0.05).No statistical differences were found on blood glucose level in hypoglycemia onset,psychiatric symptom.Conclusion The clinic data is helpful for preliminary diagnosis,and Whipple triad,hungry test,I/G＞0.3 above all.

Air Pollutants, Occupational ; analysis ; Guanidines ; analysis ; Humans ; Occupational Exposure ; analysis ; Threshold Limit Values ; Workplace

Animals ; Base Sequence ; Gene Expression Regulation ; Humans ; MicroRNAs ; genetics ; metabolism ; Molecular Sequence Data ; RNA, Viral ; genetics ; Virus Diseases ; genetics ; metabolism ; virology ; Virus Physiological Phenomena ; Viruses ; genetics ; metabolism