This study aims to explore and analyze the condition of concurrent diseases and medicine use of traditional Chinese medicine (TCM) and western medicine among the patients with insomnia. One thousand and sxity seven cases of data from 20 national hospitals' hospital information system (HIS) databases were collected. The frequent concurrent diseases included hypertension (26.9%), brain blood supply insufficiency (24.93%), cerebral infarction (19.49%), blood lipoprotein disturbance (15.28%), coronary heart disease (14.15%), headache (10.68%), chronic gastritis (8.81%), type 2 diabetes mellitus (7.87%), depressive disorder (7.4%) and anxiety disorder (6.65%). The 10 most frequently-used western drugs included alprazolam (35.99%), aspirin (25.4%), olanzapine (24.18%), cinepazide (23.06%), flupentixol & melitracen (18.74%), zolpidem (18.37%), oxiracetam (15.65%), estazolam (15%), aniracetam (13.4%) and piracetam (13.31%). The 10 most frequently-used TCM included Shuxuening injection (16.4%), Shuxuetong injection (15.18%), extract of ginkgo biloba leaf (14.71%), gastrodin (12.46%), Dengzanxixin injection (11.34%), Xueshuantong (8.53%), Danhong injection (6.37%), compound liquorice tablet (5.81%), Sanqi Tongshu capsule (5.72%) and sowthistle-leaf ixeridium injection (5.34%). Among all combined uses, the most frequent western drug use was alprazolam and olanzapine, while combined use of hypnotic drug and Huoxuehuayu formula is the most frequent. This study concludes that the concurrent diseases mainly include cardio-cerebrovascular diseases, metabolic disorders and anxiety-depression disorders, with increasing tendency of diseases types by ages, especially for cardio-cerebrovascular diseases. The most frequently-used hypnotic is alprazolam in the insomnia patients, and it is worth being concerned about the off-label use of olanzapine as an antipsychotic for the treatment of insomnia However, due to the fact that all cases data are from the inpatients, these findings have some limitations.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alprazolam ; therapeutic use ; Anti-Anxiety Agents ; therapeutic use ; Antipsychotic Agents ; therapeutic use ; Benzodiazepines ; therapeutic use ; Cerebral Infarction ; drug therapy ; epidemiology ; etiology ; Coronary Disease ; drug therapy ; epidemiology ; etiology ; Diabetes Mellitus, Type 2 ; drug therapy ; epidemiology ; etiology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Headache ; drug therapy ; epidemiology ; etiology ; Humans ; Hypertension ; drug therapy ; epidemiology ; etiology ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Sleep Initiation and Maintenance Disorders ; complications ; drug therapy ; epidemiology ; Young Adult

Objective To investigate the mechanism of the inhibitory effect of ?-ray irradiation on rat vascular smooth muscle cells(VSMC). Methods The ef fect of ?-ray irradiation on proliferation of VSMC was observed by 3?H-TdR incor poration. After ?-ray irradiation, the VSMC cell cycle change was detected b y flo w cytometry. The expression of p53, cyclin D and PCNA was investigated by Wester n Blot. Results The inhibitory effect of ?-ray irradiation on VSMC proliferati on was dose-dependent. After ?-ray irradiation, VSMC was arrested in G 1 st age, w ith the expression of p53 increased but the expression of cyclin D and PCNA decr eased. Conclusions ?-ray irradiation can inhibit the proliferation of VSMC. T he main mechanism is probably due to the induction of cell cycle arrest and inhi bition of the VSMC mitosis ,during which process, p53,cyclin D and PCNA all pla y an important role .

The relationship between neuronal activity in subthalamic nucleus (STN) and parkinsonian symptoms was investigated. Thirty-five patients with idiopathic Parkinson's disease (PD) received stereotactic surgical treatment. Microelectrode recording in STN and electromyography (EMG) on the limb contralateral to the surgical side were employed intraoperatively. Single unit firings discriminated from multiple neuronal discharges were recorded, and the correlation between neuronal activity and limb EMG was analyzed. The results showed that there were distinguished characteristics of neuronal discharges in STN and its surrounding areas. Of 346 STN neurons recorded from 36 microrecording trajectories in 35 patients, three patterns of neuronal activities were identified: irregular bursting pattern with a mean frequency of 43.0+/-11.2 Hz (56%, n=244); tonic firing pattern with a mean firing frequency of 41.0+/-12.0 Hz (15%, n=66); and regular bursting pattern with a mean frequency of 47.0+/-11.7 Hz (29%, n=126). The rhythm of regular bursting with the frequency ranging from 3.8 to 6.0 Hz was highly correlated with the frequency of limb tremor measured by EMG (r(2)=0.66, P<0.01). These cells were therefore called tremor-related neurons or tremor cells. In particular, 80% tremor cells were located in the medio-superior part of STN. In conclusion, our results suggest that microelectrode recording is a critical technique for electrophysiological localization of the target in treating PD. The tremor-related neuronal activity and movement-related neuronal activity recorded from STN are responsible for the clinical parkinsonian symptoms, suggesting that STN plays an important role in the pathophysiology of PD.
Action Potentials ; Aged ; Electromyography ; Female ; Humans ; Male ; Microelectrodes ; Middle Aged ; Neurons ; physiology ; Parkinson Disease ; physiopathology ; surgery ; Stereotaxic Techniques ; Subthalamic Nucleus ; physiopathology

In this paper, three kinds of chemotactic parameters (concentration, temperature and pH) were determined by plate assay and spore germination method to research the chemotactic response of Botrytis cinerea and Alternaria panax, and their spores on total ginsenosides. The results showed that Botrytis cinerea had strong chemotactic response at the mid-concentration of total ginsenosides (cultivation temperature was 20 degrees C and pH value was 6), and the data of chemotactic migration index (CMI) was 1.293 0, chemotactic growth rate (CGR) was 0.476 0, spore germination rate (SGR) was 53%, and dry weight of mycelial (DWM) was 0.452 6 g x L(-1); however, Alternaria panax had strong chemotactic response at the low-concentration of total ginsenosides (cultivation temperature was 25 degrees C and pH value was 6), and the data of chemotactic migration index (CMI) was 1.235 4, chemotactic growth rate (CGR) was 0.537 0, spore germination rate (SGR) was 67%, and dry weight of mycelial (DWM) was 0.494 8 g x L(-1). The results indicated that the low and middle concentration (2, 20 mg x L(-1)) of total ginsenosides had significant promoting effect on chemotactic response of these two pathogens, and the spore germination, mycelial growth rate, dry weight of mycelial of them were also significantly improved by this chemotactic response, whereas it decreased as the increase of total ginsenosides concentration.
Alternaria ; drug effects ; growth & development ; physiology ; Botrytis ; drug effects ; growth & development ; physiology ; Chemotaxis ; drug effects ; Drugs, Chinese Herbal ; metabolism ; pharmacology ; Ginsenosides ; metabolism ; pharmacology ; Panax ; metabolism ; microbiology ; Plant Diseases ; microbiology ; Spores, Fungal ; drug effects ; growth & development ; physiology

Objective To investigate the genotype of metallo-?-lactamases (MBL) produced by carbapenem resistant Pseudomonas aeruginosa in pediatric patients.Methods 59 strains of resistance to imipenem or meropenem were collected from December 2003 to November 2005 in Beijing children's hospital.Isolates were further evaluated for MBL production by two screening methods.MBL Etest strips were used to screen the phenotype of MBL production.Molecular screening for blaVIM,blaIMP,blaSPM and blaGIM was carried out using primers targeting the conserved regions of the MBL genes.The PCR fragments obtained with integron primers were sequenced on both strands.The nucleotide sequences were compared with sequences available over the Internet.Results Of the 59 carbapenem resistant Pseudomonas aeruginosa included in this study,29 (49.2%)were MBL positive using Etest methods,and 39 (66.1%) of these tested positive for MBL genes by PCR.35 (89.7%) were positive for blaIMP genes and 4 (10.3%) were positive for blaVIM genes.All isolates were negative for SPM and GIM DNA sequencing revealed that the IMP-1 was detected in 35 IMP-producing isolates,and VIM-2 was detected in 4 VIM-producing isolates.Conclusions This study has demonstrated that MBL-producing strains in pediatric are more common than in adult.IMP-1-producing strains are the main in pediatric,and VIM-2-producing strains concurred.The production of MBL is one of the important reasons of carbapenem resistant Pseudomonas aeruginosa in pediatric.It is very important to monitor the production of MBL.

OBJECTIVEHaemophilus (H.) influenzae is a gram-negative bacillus that is a common commensal organism of the human upper respiratory tract and an important cause of human diseases such as pneumonia, meningitis, septicemia, epiglottitis and cellulitis. Strains of H. influenzae are classified according to their capsular polysaccharide. There are six serotypes, designated as a through f. In addition, there are nonencapsulated strains. Although the type of infectious diseases caused by H. influenzae has changed considerably in recent years because of the widespread and routine immunization of children against type b H. influenzae (Hib), Hib remains an important pathogen. Ampicillin is the drug of choice for treating many infections caused by H. influenzae, but its usefulness has been compromised by the increasing prevalence of ampicillin-resistant strains. The continued monitoring of resistant strains by using genotyping methods may provide insights into the epidemiology of transmission. A molecular epidemiological study of ampicillin-resistant H. influenzae derived from nasopharyngeal swabs specimens of children less than 5 years of age with respiratory tract infection were investigated in this study.

METHODSA total of 899 isolates were collected from Beijing, Shanghai, and Guangzhou during 2000-2003. Susceptibility to ampicillin was determined by using E-test. Ampicillin-resistant H. influenzae strains were selected according to National Committee for Clinical Laboratory Standards (NCCLS) 2002 breakpoints. Nested PCR method with primers specific for bexA gene and b capsulate type-specific gene was established. Genotyping by pulsed-field gel electrophoresis (PFGE) and multiplex PCR assay was performed for all ampicillin-resistant H. influenzae strains.

RESULTSSeventy-four ampicillin-resistant H. influenzae strains were obtained. Two strains were positive by nested PCR, characterized as b genotype. The incidence of Hib in ampicillin-resistant H. influenzae strains was 2.7%; 38 genotypes were detected by PFGE. Detection of five types strains of clonal dissemination by PFGE accounted for 55.4% in all ampicillin-resistant H. influenzae strains. Among them eighteen H. influenzae strains belonged to one type, accounted for 24.3% in all ampicillin-resistant H. influenzae strains. Thirty one genotypes were identified by multiplex PCR assay for ampicillin-resistant H. influenzae. The identity ratio of PFGE and multiplex PCR was 63.5%.

CONCLUSIONIn Beijing, Shanghai and Guangzhou areas 55.4% of ampicillin-resistant H. influenzae strains had clonal dissemination during the 4 years.

Ampicillin Resistance ; genetics ; Anti-Bacterial Agents ; pharmacology ; Child, Preschool ; China ; epidemiology ; DNA, Bacterial ; genetics ; Drug Resistance, Bacterial ; genetics ; Electrophoresis, Gel, Pulsed-Field ; Genotype ; Haemophilus Infections ; epidemiology ; microbiology ; Haemophilus influenzae ; classification ; genetics ; isolation & purification ; Humans ; Microbial Sensitivity Tests ; Molecular Epidemiology ; Nasopharynx ; microbiology ; Polymerase Chain Reaction ; Respiratory Tract Infections ; microbiology

BACKGROUNDIt has been proposed that parkinsonian motor signs result from hyperactivity in the output nucleus of the basal ganglia, which suppress the motor thalamus and cortical areas. This study aimed to explore the neuronal activity in the globus pallidus internus (GPi) and the ventrolateral thalamic nuclear group (ventral oral posterior/ventral intermediate, Vop/Vim) in patients with Parkinson's disease (PD).

METHODSTwenty patients with PD who underwent neurosurgery were studied. Microelectrode recording was performed in the GPi (n = 10) and the Vop/Vim (n = 10) intraoperatively. Electromyography (EMG) contralateral to the surgery was simultaneously performed. Single unit analysis was carried out. The interspike intervals (ISI) and coefficient of variation (CV) of ISI were calculated. Histograms of ISI were constructed. A unified Parkinson's disease rating scale (UPDRS) was used to assess the clinical outcome of surgery.

RESULTSThree hundred and sixty-three neurons were obtained from 20 trajectories. Of 175 GPi neurons, there were 15.4% with tremor frequency, 69.2% with tonic firing, and 15.4% with irregular discharge. Of 188 thalamic neurons, there were 46.8% with tremor frequency, 22.9% with tonic firing, and 30.3% with irregular discharge. The numbers of three patterns of neuron in GPi and Vop/Vim were significantly different (P < 0.001). ISI analysis revealed that mean firing rate of the three patterns of GPi neurons was (80.9 +/- 63.9) Hz (n = 78), which was higher than similar neurons with 62.9 Hz in a normal primate. For the Vop/Vim group, ISI revealed that mean firing rate of the three patterns of neurons (n = 95) was (23.2 +/- 17.1) Hz which was lower than similar neurons with 30 Hz in the motor thalamus of normal primates. UPDRS indicated that the clinical outcome of pallidotomy was (64.3 +/- 29.5)%, (83.4 +/- 19.1)% and (63.4 +/- 36.3)%, and clinical outcome of thalamotomy was (92.2 +/- 12.9)%, (68.0 +/- 25.2)% and (44.3 +/- 27.2)% for tremor, rigidity and bradykinesia, respectively. A significant difference of tremor and rigidity was found between GPi and Vop/Vim (P < 0.05).

CONCLUSIONSDifferent changes in neuronal firing rate and the pattern in GPi and Vop/Vim are likely responsible for parkinsonian motor signs. The results support the view that abnormal neuronal activity in GPi and Vop/Vim are involved in the pathophysiology of parkinsonism.

Adult ; Aged ; Female ; Globus Pallidus ; physiopathology ; Humans ; Male ; Middle Aged ; Neurons ; physiology ; Parkinson Disease ; physiopathology ; Ventral Thalamic Nuclei ; physiopathology

OBJECTIVETo evaluate the effect of exteral use of papaverine cream on enhancement of skin graft.

METHODSFive mini-pigs were used for the study. 20 full-thickness wounds were created on the back of each animal. Along the midline of the abdomen, a 40 cm x 2 cm full-thickness skin graft was harvested and the wound sutured.The full-thickness graft was prepared and trimmed to 2 cm x 2 cm of 0.6 mm thickness split-skin grafts, which were transplanted to each wound with tie-over bolsters. The sutures were removed 2 weeks after the operation. Twelve pairs of 100%-survived skin grafts were selected and divided into group A (the left side) and group B (the right side), with each pair locating on the same and opposite position. From the day of suture removal, 2% papaverine cream was used to group A while plain cream was used to group B. The grafts were measured and observed for healing condition at the time of suture removal and the first, second, third, fourth, fifth, and sixth month. The surface area of the graft was measured and the shrinking ratio was calculated. After the animals were killed at the sixth month, samples of the skin grafts were taken and processed with 10% formalin, routine paraffin wax and Hematoxylin-eosin staining. The tissue structure was observed and the results were analyzed statistically.

RESULTSThe grafts in two groups did not have significant differences at the time of suture removal. Observations from the first to the sixth month showed that the two groups had significant differences in skin graft contracture and histological changes. HE stains demonstrated that the skin grafts in group A had less fibroblasts, more microvessels and orderly-arranged collagenous fibers.

CONCLUSIONSExternal use of papaverine cream can inhabit the contraction of skin grafts. It is a safe, effective, simple, and reliable method,which has the advantages of easy delivery,cheapness, less injury and infection,and no side effects.

Animals ; Contracture ; prevention & control ; Male ; Papaverine ; pharmacology ; Skin Transplantation ; adverse effects ; Swine ; Swine, Miniature ; Wound Healing ; drug effects

OBJECTIVETo evaluate the efficacy and safety of unilateral pallidotomy in treating Tourette syndrome (TS). The therapeutic electrophysiological mechanism of pallidotomy was analyzed according to the properties of GPi cells in TS.

METHODSTwenty-two patients underwent microelectrode-guided unilateral pallidotomy. All patients referred to surgery were previously failed with multiple non-surgical methods (psychopharmacological and behavioural therapy). Pre- and postoperative tic severities were rated by the Yale global tic severity scale (YGTSS). With the microelectrode recording technique, the properties of GPi cells in 6 patients were recorded and analyzed.

RESULTS(1) Postoperative scores of motor tics, phonic tics, overall impairment rating and global severity in YGTSS were significantly decreased (P < 0.01). The amelioration of phonic tics was less than motor tics. The follow-up data at 12 months revealed a stable efficacy. Five cases experienced transient complications included drowsiness, intracranial pneumatocele, incontinence, diplopia and slightly facial palsy after pallidotomy, there were no permanent complications such as death, intracranial, hematoma hemiplegia and visual field defect. (2) The discharge rates of GPi neurons ranged from 20 to 156 Hz, the discharge patterns include regular, irregularly bursting and clustering mode. The synchronizations of neuronal discharge in GPi with the activities of contralateral limbs were observed also by electromyogram recorded at the same term.

CONCLUSIONS(1) Pallidotomy is proven to be a safe and effective method to treat TS, it provides a significant immediate and short term reduction of tic severity in intractable Tourette' syndrome. The long term effect of pallidotomy is confirmed also. Pallidotomy is applied to those patients with high tics scores, severe self-injured behaviors or fail to medicine treatment. (2) The low discharge rate, abnormal firing pattern and synchronized neuron are the properties of GPi neurons in TS, and maybe the pathophysiological basement of tics. Eliminated the neurons with abnormal activity in GPi, and decreased the activity of CSTC circuits maybe the therapeutic mechanism of pallidotomy.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Globus Pallidus ; physiopathology ; surgery ; Humans ; Male ; Microelectrodes ; Stereotaxic Techniques ; Tourette Syndrome ; physiopathology ; surgery ; Treatment Outcome

BACKGROUNDSubthalamic deep brain stimulation (STN-DBS) has been shown to be effective in the treatment of Parkinson's disease. The site for permanent stimulation is still in debate. This study aimed to assess the position of active contacts in relation to the subthalamic nucleus.

METHODSWe reviewed the location of 40 electrodes in 34 patients who underwent STN-DBS. The position of electrode was evaluated by postoperative magnetic resonance imaging (MRI). The position of active contacts was compared with the subthalamic nucleus (STN) determined by intraoperative electrophysiological mapping and postoperative MRI.

RESULTSThe average position of the 40 active contacts was (11.7 + or - 1.2) mm lateral, (0.6 + or - 1.3) mm anterior, and (0.7 + or - 1.4) mm vertical to the midcommissural point. The dorsal margin of the STN was (11.6 + or - 1.1) mm lateral, (0.2 + or - 1.1) mm anterior, and (1.3 + or - 1.1) mm vertical to the midcommissural point. When compared with the dorsal margin of the STN, the active contacts were located more dorsally (P = 0.033) and anteriorly (P = 0.012), no significant difference was found in the lateral direction (P = 0.107). When compared with the position of the STN, 26 (65%) of active contacts were located in the region dorsal to the STN, only 13 (32.5%) were located in the upper two-thirds portion of STN.

CONCLUSIONSThe site for permanent stimulation appears to be in the subthalamic region dorsal to the STN, close to the dorsal margin of the STN. Besides the dorsal portion of the STN, other structures such as fields of Forel H and zona incerta may also be involved in the therapeutic benefit of deep brain stimulation.

Adult ; Aged ; Deep Brain Stimulation ; Electrophysiology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Parkinson Disease ; pathology ; physiopathology ; therapy ; Subthalamic Nucleus ; pathology ; physiopathology