Objective: To compare and evaluate the efficacy and adverse reactions of tizanidine, baclofen and eperisone for treatment of limb spasticity in patients after stroke. Method: One hundred and three patients with stroke were enrolled in this prospective, randomized, controlled study. They were randomly divided into 4 groups: Tizanidine (n = 30), baclofen (n = 25), eperisone (n = 22) and control (n = 26) groups. The muscular tone, motor function and daily live activities (ADL) were evaluated with the modified Ashworth scale (MAS), Fugl-Meyer ssessment (FMA) and modified Bathel index (BI) respectively 4 and 12 weeks before and after the medication. Results: Circled digit oneTwelve weeks after the medication, the MAS scores of the upper and lower limbs of the patients were decreased in the 3 treatment groups as compared to the control group (P < 0.05 all). The average decrease scores of the upper limbs in the tizanidine, baclofen, eperisone and control group were 0.8 ± 0.6, 0.7 ± 0.6, 0.7 ± 0.4, and 0.4 ± 0.4, respectively; and those of lower limbs were 0.8 ± 0.6, 0.7 ± 0.5, 0.7 ± 0.5, and 0.5 ± 0.5. However, there was no significant difference among the 3 treatment groups (P > 0.05). Circled digit twoThe FMA scores of the upper limbs in patients of the 4 groups showed that there were no significant differences before and after the treatment (P > 0.05 all); the FMA scores of the lower limbs in patients of the 4 groups after the 12-week treatment were significantly higher than those before treatment. The average increased scores were 5 ± 3, 6 ± 5, 5 ± 4, and 4 ± 4, respectively (P < 0.05 all), and there were no significant differences between the 4 groups (P > 0.05). Circled digit threeCompare to the scores before the treatment, the MBI showed that there were significant differences in the average scores in the 4 groups 12 weeks after the treatment (P < 0.05 all), and the average increased scores were 27 ± 12, 25 ± 14, 25 ± 12, and 21 ± 11. There were no significant differences between the 3 groups and the control group (P > 0.05). Circled digit fourBlood, urine, liver and renal function tests of all patients were in the normal range before and after treatment. 10% and 8% of patients in the tizanidine and baclofen groups experienced drowsiness; 6.7%, 8%, and 4.5%. of patients in the tizanidine, baclofen, and eperisone groups had gastrointestinal discomfort; 6.7% and 8% of patients in the tizanidine and baclofen groups had blood pressure drop; and 22.7% of patients in the eperisone group had generalized weakness. The symptoms were relieved in all patients after reduce or stop the medication. Conclusion: Tizanidine, baclofen and eperisone have obviously effects for reducing muscular tone and relieving spasticity. Their therapeutic effects has no differences, but the three medicines did not show significant effect on functional recovery.

AIM: To observe the application of Suresight handheld auto- refractometer in measuring diopter of infants in Community Health Service Center.
METHODS:Totally 836 cases ( 1 672 eyes ) from June 2013 to December 2013 were examined diopter of infants by Suresight handheld auto-refractometer in Community Health Service Center.
RESULTS: Within 1 672 eyes of 836 infants were examined, 202 eyes were diagnosed ametropia, 38 eyes were suspicious, 240 eyes were transferred to the department of ophthalmology, the referral rate was 14.35%; 172 eyes were diagnosed ametropia, and the diagnosis rate of the referral patients was 71. 67%. Among 172 eyes, 46 eyes were provided with corrected glasses, accounting for 2. 75% of the number of screening, and 126 eyes were given intensive monitoring, accounting for 7.54% of the number of screening.
CONCLUSION: Application of Suresight handheld auto-refractometer in refraction screening for infants in Community Health Service Center is convenient and effective. With two - way referral between community health service center and department of ophthalmology can monitor and intervene vision development of infants much earlier.

Objective To investigate the prevalence of cardiovascular and cerebrovascular diseases in the army old male hypertensive patients in Beijing. Methods From October 2011 to April 2014, old male patients in the geriatric department of the General Hospital of Chi-nese People's Liberation Army were enrolled and categorized into 3 groups: normotensive, well-controlled hypertensive and poorly-con-trolled hypertensive groups. The prevalence of cardiovascular and cerebrovascular diseases was recorded and binary logistic regression was used to analyze the differences among the groups. Results 719 old male patients were enrolled, 228 in normotensive group, 389 in well-con-trolled hypertensive group and 102 in poorly-controlled hypertensive group. Compared to normotensive group, there was more incidence of angina (OR=2.547, P<0.001), myocardial infarction (OR=2.493, P=0.003), cerebral thrombosis (OR=3.438, P=0.003) and peripheral artery atherosclerotic disease (OR=1.766, P=0.026) in the well-controlled hypertensive group, and it was more of angina (OR=4.123, P<0.001), la-cunar infarction (OR=2.810, P=0.020), cerebral thrombosis (OR=3.484, P=0.001) and peripheral artery atherosclerotic disease (OR=3.773, P<0.001) in the poorly-controlled hypertensive group. There was not significant difference of prevalence of cerebral hemorrhage (0.9%, 1%and 1%, respectively). Conclusion In the army old male hypertensive patients in Beijing, control rate of blood pressure was higher than com-mon population, but the prevalence of ischemic diseases was still higher than in the normotensive patients. Anti-hypertension and control of other risk factors could reduce the mobidity of cerebral haemorrahge.

Objective To evaluate the therapeutic effectiveness of treating adrenal gland neoplasms by CT-guided absolute alcohol injection. Methods Eleven patients with adrenal gland neoplasms were examined by CT to identify the lesion′s size, location, and the relationship with its surrounding tissue. The needling direction was first chosen, and the syringe needle was placed at the center of tumor or the destined position. Absolute ethyl alcohol was injected after rescanning to confirm the position of syringe needle was inerrant. The blood sugar and blood pressure were checked before operation. After operation, analysis of the clinical manifestations was performed and the blood sugar and blood pressure were measured at once, 24 h, 48 h, one week, one month, and two months, respectively. To observe the absorption of the lesions, postoperative follow-up CT scans were performed at one month and later on. Results Significant differences in blood pressures and blood sugar were observed between preoperation and 24 hours after the operation (P

Objective To observe the effect of botulinum toxin A (BTX-A) on spasticity of upper extremity with different functional status after stroke.Methods 32 post-stroke patents with upper extremity spasticity were divided into the good function group (n=13) and poor function group (n=19) according to the function of upper extremity. All patients in two groups were treated with injection of domestic BTX-A at the biceps brachii and rehabilitation therapy. The efficacy was assessed with rang of motion, Modified Ashowrth Scale (MAS), Fugl-Meyer Assessment (FMA) and Mot-FIM upper extremity before and 8-week after treatment.Results After treatment, the rang of motion and FMA scores of patients in two groups improved ( P<0.05), but the good function group was superior to the poor function group; the scores of MAS of two groups were not different ( P>0.05); the scores of Mot-FIM upper extremity of the patients in two groups increased ( P<0.05), and there was no significant difference between two groups ( P>0.05).Conclusion The effect of BTX-A injection at the biceps brachii on post-stroke patients with good function of upper extremity is superior to the patients with poor function of upper extremity.

Humans ; Rhinitis, Allergic, Perennial ; Rhinitis, Allergic, Seasonal

Hospitals ; statistics & numerical data ; Humans ; Population Surveillance ; Quality Control ; Wounds and Injuries ; epidemiology

Accidents, Occupational ; mortality ; Humans ; Hydrogen Sulfide ; poisoning

Objective To retrospectively analyze clinical manifestations of autonomic nervous system (ANS) and skin sympathetic response (SSR) in Lambert-Eaton myasthenic syndrome (LEMS).Methods Fifty-three LEMS patients' medical records were reviewed and information regarding clinical symptoms and signs of ANS and SSR testing results were collected.Results ( 1 ) The most common initial symptom of LEMS was weakness of lower extremities ( n =41 ) and the most common symptom of ANS dysfunction was constipation ( n =25 ) and dry-mouth ( n =23),which could be occurred before the onset of the legs (n =7).(2) In symptoms of ANS,cardiovascular system dysfunction was found in 4 patients include one of ingone of bradycardia,one of postural hypotension and 2 of tachycardia- Secretory glands dysfunction was found in 34 patients:23 dry-mouth,6 dry-eyes,and 8 patients sweating dysfunctions.Twenty-eight patients complained of alimentary dysfunction including constipation and diarrhea.Bladder dysfunction was found in 2 patients,who complained of urinary incontinence.Seven male patients complained of sexual dysfunction.Abnormal skin scratch test was found in 17 patients.(3) SSR was performed in 33 patients and 18 found abnormal.Conclusions ANS manifestations are common and prominent in LEMS patients.SSR abnormality is also common in LEMS.More electrophysiology tests are needed in LEMS patients.

Objective To examine clinical features, neuroimaging presentation and treatment of intracranial fungal granulomas (ICFG) in order to improve the accuracy rates of diagnosis and cure. Methods Three pathologically proven cases with ICFG were retrospectively analyzed. Cases of ICFG reported in literature were also summarized. Results Among the 3 patients with ICFG, 1 patient had a history of head trauma and craniotomy and 1 had a history of type 2 diabetes mellitus and a long history of exposure to doves. In all 3 patients, the symptoms started with headache and vomiting, accompanied by low-grade fever, convulsion, and cranial nerve deficits. Intracranial mass lesion was revealed on brain computed tomography (CT) scan and (or) magnetic resonance imaging (MRI) with or without intravenous contrast. CT scan showed low-density lesions and granulations with ring and homogenous enhancement, indicating fungal abscesses. MRI in all 3 cases showed one or multiple circumscribed intracranial space-occupying lesion, with ring, heterogeneous contrast enhancement and perilesional edema. The treatments were initiated with craniotomy and surgical resection of granulations followed by intravenous injection of amphotericin B (AMB) combined with fluconazole. The daily administration of AMB was increased gradually from 0.25-1.50 mg/kg and the total dosage of 2-4 g should be achieved within 3 months. The combination therapy with fluconazole (400 mg/d ) was also given by intravenous injection. To increase penetration into cerebrospinal fluid, intrathecal injection of AMB had also been given at the maximum dosage of 1 mg every time, twice a week. Two patients were administered fluconazole (200 mg/d ) orally for 3, 6 months consecutively after completing the combination therapy of AMB with fluconazole, while the other patient refused continuous antifungal treatment 1 month postoperatively. All 3 patients were followed up for a period between 3, 24, 48 months. The 2 patients that completed full antifungal treatment were cured without recurrence. The other patient had improved transiently after operation but died after 3 months. Conclusions Because no distinct chnical and neuroimaging features are presented in ICFG, it is difficult to diagnose preoperatively. Indications for surgery include diagnosis, relief mass effect and increase efficiency of drug treatment. Use of appropriate and completed antifungal treatment decreases mortality. The treatment requires continued and long-term administration of antifungal medication to prevent relapses, whether granulomas are totally removed or not.