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 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 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 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.

Objective The purpose of this study was to discuss the effect of visible light therapeutic equipment accompanied with electrolyzed-oxiding water (EOW) on pressure ulcer above the second phase. Methods We divided 44 patients with pressure ulcer above the second phase into the test group (23 cases, 28 spots) and the control group (21 cases, 25 spots). The test group received local decompression, debridement with EOW, exposure to visible light for 20 minutes, 10 times per day. The control group adopted local decompression, debridement with normal saline and local application of burn cream, 3 times per day. Results The effective rate of the test group was apparently higher than that of the control group (P<0.05). The healing time was also shorter than that of the control group (P<0.01). Conclusion Treatment of pressure ulcer above the second phase with visible light therapeutic equipment accompanied with electrolyzed-oxiding water proved to be an effective treatment method.

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.

Objective: To establish the methods for extraction and isolation of punicalagin from pomegranate peel, and further study the purification and quantification of punicalagin. Methods: Using an ultrasonic-assisted extraction method, punicalagin in pomegranate peel was extracted at room temperature by 50% ethanol with 20-fold volume of raw material. The content of punicalagin in the crude extract was determined by HPLC. To optimize the purification process of punicalagin, static adsorption and desorption experi-ments were employed to study five kinds of macroporous adsorbent resins (D101, A8-8, NKA-9, HPD-100 and HPD-500) for the one with the highest purification efficacy of punicalagin. In addition, the technical parameters of the macroporous adsorbent resin were opti-mized to obtain punicalagin with higher purity. Punicalagin was further separated and purified by using a reverse phase MCI GEL CHP20P column. Results:HPD500 resin showed the best ability to absorb and separate punicalagin in among five kinds of macro-porous adsorbent resins. The best technical parameters were as follows:the mass concentration of sample solution was 15 mg·ml-1 , the loading amount was 2BV, the pH was 2 and the eluting solvent was 8BV of 30% ethanol. With the best process as described a-bove, the content of punicalagin extracted from pomegranate peel increased from 10. 3% to 30. 7%. The obtained punicalagin could be further purified to 61. 3% from 30% in ethanol eluate by the reverse phase MCI GEL CHP20P column. Conclusion:HPD500 resin is the most effective in the purification of punicalagin from pomegranate peel, and the content of punicalagin can be dramatically increased after the purification by a reverse phase MCI GEL CHP20P column. The optimized process shows good reproducibility and stability.

Background and purpose:Radiotherapy (RT) is one of the most important therapeutic tools for esophageal cancer. Because tumors are heterogeneous, including for18F-FDG uptake and, most likely, for radioresistance, selective boosting of high FDG uptake zones within the tumor has been suggested. Therefore, it is critical to know whether the location of these high FDG uptake patterns within the tumor remains stable during RT.Methods:Twenty-two patients with esophageal squamous cell carcinoma treated with concurrent chemo-radiation underwent repeated18F-FDG PET-CT scans before RT and after 20 fractions of RT. On all scans, the high and low FDG uptake regions were auto-delineated using several standard uptake value (SUV) thresholds, varying from 40% to 70% of SUVmax on the pretreatment scan [gross tumor volume (GTV)40%pre, GTV50%pre, GTV60%pre, GTV70%pre] and from 70% to 90% of SUVmax on the dur-treatment scan (GTV70%dur, GTV80%dur, GTV90%dur) and ifxed thresholds of 2.5 and 5 (GTV2.5pre, GTV5pre). The volumes and overlap fractions (OF) of these delineations were calculated to demonstrate the stability of the high FDG uptake regions during RT.Results:The high uptake regions within the tumor during RT largely corresponded (OF>70%) with the 50% SUVmax high FDG uptake area (GTV50%pre) of the pretreatment scan. The hotspot within the residual area (GTV90%dur) was completely within the GTV and pre-radiotherapy high uptake regions (OF=100%). Although the location of the high FDG uptake patterns within the tumor during RT remained stable, the delineated volumes varied markedly.Conclusion:The location of the high FDG uptake areas within the tumor remained stable during RT. This knowledge may enable selective boosting of high FDG uptake areas within the tumor.

Objective To observe the value of the high frequency color Doppler uItrasonography in emergency operation of flexor tendon injuries in the hand.Methods Totally 21 patients of flexor tendon injuries in the hand underwent surgical exploration with high frequency probe.The extent of the tendon injuries,the retracted parts of the ruptured tendon and the blood supply were observed.Results The extent of the tendon injuries,the poison of broken ends were clearly distinguished with high frequency probe.The continuous tendon fibrous of layered high echo and sheath thin layer low echo complete broke and replaced with low or no echo.Conclusion Intraoperative uhrasonography of flexor tendon iniuries is important tO shorten operation time,reduce the injury of surrounding tissues,relieve local adhesion and ensure vascular recanalization after operation.