Objective To determine whether pupil response to dilute tropicamide could be used as a diagnostic test for Alzheimer's disease (AD). Methods Pupil diameters of both eyes were measured simultaneously by an infra red automatic pupil diameter recorder and analyzer every 0 1 second for 30 minutes after instillation of 0 01% tropicamide to one eye and normal saline to the other. Three groups of patients were studied: 52 patients with AD, 33 with vascular dementia (VD), and 58 elderly controls. The percent change in pupil diameter of the treated eye was examined automatically by the analyzer. After finding the cut off point for differential diagnosis by receiver operator characteristic curve (ROC), its sensitivity, specificity and Kappa coefficient were calculated. Results Mean percent change in diameters of the treated eye showed a trend of fastest maximum dilation in AD group, and was significantly different from other groups at all the measurement time points after 10th minute instillation. The difference was most significant at the 18th minute after instillation, and 15% was used as a cut off point, the sensitivity was 0 81,specificity 0 79 0 82, and Kappa coefficient 0 62 0 67. Conclusions Pupil dilation test could be used as a screening method in the diagnosis of Alzheimer's disease, or as a tool for differential diagnosis between AD and VD.

Objective To evaluate the surgical treatment of carotid artery stenosis. MethodAccording to the level and degree of the stenosis, different operations were performed on 120 patients who suffered from the extracranial carotid stenosis. Treatment result was retrospectively reviewed. ResultSurgery was successful in all the patients. We performed carotid endarterectomy on 111 cases and other operations on 9 cases. The incidence of postoperative complications was low, especially for carotid endarterectomy. ConclusionCarotid endarterectomy is still the main therapy for the treatment of carotid artery stenosis with a satisfactory result.

AIM To establish the quality standard for Tibeten medicine Ershiwuwei Feibing Pills [Inula racemosa Hook.f.,Swertia bimaculata (Sieb.et Zucc.) Hook.Thors.ex Clarke,Phyllanthus emblica Linn.,Terminalia billerica (Gaertn.) Roxb.,etc.].METHODS TLC was applied to the qualitative identification of L racemosa,S.bimaculata,P.emblica and T.billerica,and HPLC was adopted in the quantitative determination of alantolactone,oleanolic acid,gallic acid and hydroxysafflor yellow A.RESULTS The TLC spots were clear without negative interference.Alantolactone,oleanolic acid,gallic acid and hydroxysafflor yellow A showed good linear relationships within the ranges of 4.324-216.2 μg/mL (r =0.999 9),32.222-1 611.1 μg/mL (r =0.999 9),4.072-203.6 μg/mL (r =0.999 9) and 4.266-213.3 μg/mL (r =0.999 9),whose average recoveries (RSDs) were 100.6％ (0.93％),100.3％ (2.1％),101.5％ (3.0％) and 100.1％ (1.8％),respectively.CONCLUSION This simple method can be used for the rapid quality control of Ershiwuwei Feibing Pills.

Objective To evaluate the clinical results of femoral-deep femoral crossover bypass in the treatment of long-segment unilateral iliac artery occlusive disease.Methods From July 1995 to December 2010,40 patients (28 males,12 females,aged from 66 to 90,with mean age of 73) with comprehensive unilateral iliac-superficial femoral arteriosclerosis obliterans were enrolled in this procedure.All patients suffered from unilateral common iliac,external iliac,common femoral,and superficial femoral arteriosclerosis obliterans.These patients were treated with femoral-deep femoral crossover bypass.Postoperative ankle-brachial index,blood flow velocity and patency rates in 5,7 and 10 years and limb salvage rates in 5,7 and 10 years were evaluated.Results There was no perioperative mortality nor extremity amputation.35 (87.5％ ) patients were followed-up from 1 to 13 years (mean 5.7 y).Anklebrachial index rose from preoperative 0.23 ± 0.10 to postoperative 0.55 ± 0.11 (t =15.91,P =0.000 ).Popliteal arterial velocity rose from preoperative ( 14 ±6) cm/s to postoperative (34 ± 10) cm/s (t =15.63,P =0.000) ; Tibial arterial velocity rose from ( 10 ±4) cm/s to (22 ±7) cm/s (t =15.71,P =0.000).The primary and secondary patency rates were 60.1％,44.3％,25.3％,and 93.5％,86.8％,57.9％ at 5,7 and 10 years,respectively.Limb salvage rates were 97.5％,95％,and 90％,at 5,7 and 10 years,respectively.Conclusions Femoral-deep femoral crossover bypass is safe and reliable in treating certain unilateral iliofemoral occlusive disease,especially for high-risk old patients or those who are not indicated for endovascular therapies or direct aortic approaches.

Objective To evaluate diagnosis and surgical treatment of carotid body tumors.Methods It was retrospectively reviewed that the diagnostic approaches, surgical operation methods and its related complications in 70 carotid body tumor cases treated in our hospital from May 1986 to May 2008.Results Diagnosis was established by computer tomography angiography (CTA) or magnetic resonance angiography (MRA). Surgical excision was successfully performed in 63 cases with 72 tumours. There were no postoperative deaths. Two cases developed hemiplegia following surgery. Temporary cranial nerve palsy occurred in 17 cases while permanent nerve palsy occurred in 4 cases. Sixty-two cases were followed-up from 6 months to 5 years. There were no deaths in operative cases, with local tumor recurrence in 2 cases and 3 cases died due to remote metastasis. Conclusion CTA or MRA is sufficient for the diagnosis and preoperative assessment of carotid body tumor and its related structures. Surgical modality should be adjusted according to the relationship between the tumor and the carotid artery. Full exposure of the surgical area,careful control of intraoperative bleeding and persistent maintainance of blood flow to the brain are important measures for successful surgery.

Objective To describe the prevalence and risk factors of insomnia among adults in YiBin City. Meth?ods Using multi-stage stratified cluster sampling, 12000 subjects over 18 years old were identified in YiBin City. The subjects were screened using the insomnia survey self-edited and risk factors of insomnia were identified through logistic analysis. Results A total of 11227 subjects completed the survey in which 1671 people (14.9%, 95%CI:14.2%~15.5%) were diagnosed insomnia using ICD-10. Among them, 9.4% (157 patients) had seeked for professional help. The multi?variate logistic analysis showed that low level of life quality(OR=2.42,P<0.01), jobless(OR=1.87,P<0.01), over 60 years old(OR=1.69,P<0.01), fewer years of education(OR=1.41,P<0.01), female(OR=1.41,P<0.01)and lower annu?al per capita income(OR=1.15,P=0.01)were risk factors in insomnia people. Conclusion The incidence of insomnia is high in YiBin city. Sleep quality in high-risk group needs more attention and corresponding measures should be taken in order to increase the rate of asking for help in insomnia people.

Objective To evaluate open and endovascular procedures for the treatment of visceral arterial naeurysms.Methods Clinical data of 93 cases were reviewed from Jan 2001 to Jan 2011,including 47 males,and 46 females.Splenic artery aneurysm in 45 cases,superior mesenteric artery aneurysm in 15 cases,renal artery aneurysms in 10 cases,common hepatic artery aneurysm in 7,celiac artery aneurysms in 11 and gastroduodenal artery aneurysm in 5 cases.All cases had either open procedures or endovascular procedures after comprehensive evaluation.Results Surgical open procedures were performed on 34 cases,and endovascular procedures were performed on 59 cases.The perioperative complication rate were 52.9％ and 13.6％ for open and endovascular groups respectively.The mean follow-up time was 36.8 months ( 11 months to 10 years).1 -year survival rate and 5-year survival rate were 100％and 60.6％ in open surgery group,compared with 100％ and 84.5％ in endovascular group.Conclusions Endovascular repair is effective for visceral artery aneurysm with lower perioperative complication rate and better long-term survival rate.

Listeria monocytogenes is a pathogenic bacterium, therefore, it is essential for food safety monitoring to establish a rapid and specific detecting method. In this study, immunomagnetic beads and selective medium were combined to detect Listeria monocytogenes at different concentrations (10(1)-10(5) CFU/mL). Other three types of Listeria spp., Staphylococcus aureus and Vibrio parahaemolyticus were also detected to conduct the cross-reaction analysis. Meanwhile, contaminated milk samples were prepared to explore the limit of detection of immunomagnetic beads combining with selective medium. Results showed that Listeria monocytogenes with the concentration of 10(3) CFU/mL and above was successfully detected. Milk samples were detected within 6 hours, with a detection limit of 0.7 CFU/mL. The method developed is capable of detecting milk samples within 30 h, which is 38 h faster compared with national standard method with the same sensitivity.
Bacteriological Techniques ; methods ; Culture Media ; chemistry ; Immunomagnetic Separation ; methods ; Listeria monocytogenes ; growth & development ; isolation & purification ; Sensitivity and Specificity

Objective:Human leukocyte antigen(HLA)B27 is a susceptibility allele of ankylosing spondylitis(AS),and HLA-B27 antigen typing is an important indicator for clinical diagnosis of AS,but current typing methods such as sequence specific primer polymerase chain reaction(PCR-SSP)still possess limitation.Therefore,this study aims to analyze the correlation between B27 subtypes and susceptibility to AS in Hunan Province by applying high-resolution polymerase chain reaction-sequence-based typing(PCR-SBT). Methods:Peripheral blood of 116 patients with suspected AS(suspected AS group)and 121 healthy volunteers(control group)admitted to the Second Xiangya Hospital from January 2020 to December 2020 were collected for HLA-B genotyping by PCR-SBT.Among the patients in the suspected AS group,23 patients were finally diagnosed with AS(confirmed AS group),and the remaining 93 undiagnosed patients served as the non-confirmed AS group.PCR-SBT and PCR-SSP were used to detect HLA-B27 typing in 116 patients with suspected AS,and the results of the 2 methods were compared. Results:The HLA-B27 allele frequency in the suspected AS group was significantly higher than that in the control group[11.63%vs 2.48%;P<0.001,odds ratio(OR)=5.18,95%confidence interval(CI)2.097 to 12.795].B*27:04,B*27:05,B*27:06,and B*27:07 were detected in the suspected AS group and the control group.The frequency of the B*27:04 allele in the suspected AS group was significantly higher than that in the control group(9.48%vs 1.24%;P<0.001,OR=8.346,95%CI 2.463 to 28.282).The positive rate of B27 in the suspected AS group and the confirmed AS group(B27+/+ and B27+/-)was significantly higher than that in the control group(χ2=16.579,P<0.001;χ2=94.582,P<0.001,respectively).Among the confirmed AS group,21 were HLA-B27 carriers,and the B27 positive rate in the confirmed AS group was 91.3%.PCR-SBT could achieve high resolution typing of the HLA-B gene locus,with higher sensitivity,specificity,positive predictive value,negative predictive value,and accuracy than PCR-SSP. Conclusion:PCR-SBT typing analysis shows a strong correlation between HLA-B * 27:04 and AS in Hunan province.The PCR-SBT method can be used as the preferred option for the auxiliary diagnosis of clinical AS.

Objective:To investigate the clinical efficacy of pancreaticodudenectomy (PD) using anterior approach in situ technique for pancreatic head cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 285 patients with pancreatic head cancer who were admitted to the First Affiliated Hospital of Kunming Medical University from January 2012 to June 2018 were collected. There were 164 males and 121 females, aged from 40 to 76 years, with an average age of 57 years. Of the 285 patients, 196 patients who underwent PD using anterior approach in situ technique were set as anterior approach group, 89 patients who underwent PD using traditional approach were set as traditional approach group. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Follow-up was performed by outpatient examination, telephone or network interview once every 2 to 3 months to detect tumor recurrence, metastasis and survival of patients up to December 2018. The endpoint of follow-up was death of patients, and the secondary endpoint of follow-up was tumor recurrence or metastasis. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed by the t test. Measurement data with skewed distribution were represented as M (range), and comparison between groups was analyzed by the Mann-Whitney U test. Count data were represented as absolute numbers or percentages, and comparison between groups was analyzed by the chi-square test. Kaplan-Meier method was used to draw the survial curve and calculate the survival rates. Survival analysis was done by the Log-rank test. Results:(1) Surgical situations: 285 patients underwent surgery successfully. Cases with pylorus-preservaction, cases with superior mesenteric vein/ portal vein (SMV/PV) resection and reconstruction (end to end anastomosis, artificial vascular replacement, lateral wall resection and anastomosis), operation time, volume of intraoperative blood loss were 118, 37 (17, 11, 9), (303±107)minutes, 350 mL(range, 100-750 mL) in the anterior approach group, and 48, 9 (7, 1, 1), (335±103)minutes, 400 mL(range, 100-900 mL) in the traditional approach group, respectively, showing no significant difference between the two groups ( χ2=0.990, 3.474, t=0.722, Z=1.729, P>0.05). (2) Postoperative situations: the rate of R 0 resection, the number of lymph node dissected, the number of positive lymph node dissected, rate of nerve invasion, rate of vascular invasion, cases with postoperative severe complica-tions, the number of perioperative death, cases with postoperative chemotherapy were 93.88%(184/196), 12(range, 5-19), 4(range, 0-15), 45.41%(89/196), 31.12%(61/196), 28, 3, 69 in the anterior approach group, and 85.39%(76/89), 7(range, 4-17), 5(range, 0-13), 32.58%(29/89), 23.60%(21/89), 11, 2, 41 in the traditional approach group, respectively. There were significant differences in the rate of R 0 resection, the number of lymph node dissected, rate of nerve invasion between the two groups ( χ2=5.506, Z=4.637, χ2=4.149, P<0.05), while there was no significant difference in the number of positive lymph node dissected, rate of vascular invasion, cases with postoperative severe complications, the number of perioperative death, cases with postoperative chemotherapy between the two groups ( Z=0.052, χ2=1.962, 0.192, 0.001, 3.048, P>0.05). (3) Follow-up: of the 285 patients, 252 and 228 achieved the secondary endpoint and the endpoint of follow-up respectively with the follow-up time of 35 months (range, 6-58 months). There were 181 and 176 of 196 patients in the anterior approach group achieving the secondary endpoint and the endpoint of follow-up respectively with the follow-up time of 38 months (range, 6-58 months). There were 71 and 52 of 89 patients in the traditional approach group achieving the second endpoint and the endpoint of follow-up respectively with the follow-up time of 33 months (range, 7-53 months). The median tumor free survival time and median overall survival time were 31 months and 37 months in the anterior approach group, respectively, versus 24 months and 31 months in the traditional approach group. There was a significant difference in the tumor free survival between the two groups ( χ2=7.646, P<0.05), while no significant difference in the overall survival between the two groups ( χ2=3.265, P>0.05). Conclusion:PD using anterior approach in situ technique is safe and feasible for pancreatic head cancer, which can improve the rate of R 0 resection and prolong the tumor free survival time of patients.