Objective To explore the early clinical characteristics of multiple system atrophy (MSA) in the elderly,and provide the basis for early diagnosis.Methods Totally 102 cases with probable MSA in elderly patients were retrospectively analyzed to understand the beginning symptom,clinical features and assistant examination results,combined with the literature review.Results Among the 102 cases diagnosed as probable MSA (61 cases were male and 41 cases were female),57cases (55.9％) were diagnosed as parkinsonism dominant MSA (MSA-P) subtype and 45 cases (44.1％) as cerebellar dominant MSA (MSA-C)subtype.In the beginning symptom,27 cases appeared autonomic dysfunction,including 15 cases (26.3％) in MSA P subtype and 12 cases (26.6％) MSA-C subtype; 14 cases manifested as dysuresia,11 cases as orthostatic hypotension,and 8 cases as sexual dysfunction.Parkinsonism as the beginning symptom was in 49 cases,among whom 24 cases were of abnormal gait,3 cases of resting tremor,16 cases of muscle rigidity,and 15 cases of slowed movement.Cerebellar symptoms as the beginning symptom were in 33 cases,with gait and limb ataxia of 27 cases,dysarthria of 6 cases,nystagmus of 2 cases.Pyramidal tract signs as the beginning symptom were in 2 cases.There was early misdiagnosis of 36 cases (35.3％).Conclusions As wide variety of early clinical features,MSA can be easily misdiagnosed.The clinical features and assistant examination should be paid attention to improvement of the accuracy of early diagnosis.

Objective: To explore the therapeutic mechanism of Qingnao Yizhi Formula (QYF) for vascular dementia and multi - infarct dermentia. Methods: In- vitro rabbit neuron culture was utilized to investigate the effect of QYF on glutamic - acid - induced neuron injury. Results: QYF could increase the survival rate of iniured neuron(P

Objective To study the small intestinal absorption patterns of glimepiride in rats. Methods A rat model of small intestinal absorption in vivo was employed in this study. The small intestinal absorption rate of glimepiride was detected by high performance liquid chromatography. Results At the low and high concentrations of glimepiride, the average small intestinal absorption rates were 0.233 6 h -1 and 0.217 8 h -1 , respectively. Conclusion The small intestinal absorption pattern of glimepiride might be passive diffusion.

Objective:To summarize endoscopic management of cerebrospinal rhinorrhea and position-determining means.Method:Fifteen cases of cerebrospinal rhinorrhea treated by endoscopic approach at our institution were analyzed retrospectively.Aetiology included accidental trauma (10), surgical trauma (4), idiopathic (1). All patients presented with CSF rhinorrhea.Six cases were operated after failure of conservative treatment. Two cases after failure of neurosurgical repair were referred to our department. The largest defect was as big as 2.5 cm×1.5 cm. All patients were scanned by computed tomography and magnetic resonance imaging and confirmed by biochemistry test.Ten patients received high resolution spiral computed tomography bonding ventriculography.Result:We performed intranasal endoscopic repair in all 15 patients. All repairs were successful at the first attempt with a mean follow up of 20 months. One patient had light headache postoperatively and relieved with conservative treatment. All defects of skull base detected by computed tomography and ventriculography were confirmed in the operation.Conclusion:Intranasal endoscopic repair of cerebrospinal rhinorrhea can be an effective method. High resolution spiral computed tomography scan combined with ventriculography is a precise position-determining means. With the advancement of instrument and operative skill,the scope of endoscopic repair will further extend.

Objective To summarize the clinical effects of one stop hybrid approach for treating the tetralogy of fallot complicated with aorta pulmonary collateral arteries. Methods From Janu 2008 to June 2013, 79 cases of tetralogy of fallot were complicated with aorta pulmonary collateral arteries with mean age (5.4±3.9) years and weight (18.2±5.7) kg. All patients were diagnosed by echocardiography examination and accepted 64-row CT for demonstration of no dysplasia in pulmonary ressels, McGoon index was (1.7±0.6) and Nakata index was (176.7±7.3). 76 cases had aorta pulmonary collateral arteries for preliminary screening, and accepted cardiovascular angiography before operation. 3 cases were misdiagnosed before surgery and were confirmed by cardiovascular angiography after operation. Results There were 4 deceased cases with an operative mortality of 5.1%. 1 case died of lung infection and 3 cases died of refractory heart failure. In all aorta pulmonary collateral arteries, the smallest diameter was 2.5 mm, the largest was 9.4 mm, average (5.3±2.1) mm. 2 to 21 coils were implanted in respective case with an average of 10.2 coils per case. The maximum number of coils implanted in 1 single ressel was 9. The average number of ressels occluded was 3.7 (range from 1 to 11 ressels) in each case. One case received second closure due to re-open of collateral arteries on neo-vasculanigation. 14 cases had lung infection and 3 cases had pulmonary edema post operation. 75 cases were followed up for 3-72 months. 4 cases with post operative heart function of NYHA gradeⅢtoⅣand all other cases with gradeⅡon higher. Conclusions Peri-operative hybrid management for aorta-pulmonary collateral arteries can increase the operative success rates and reduce complications.

Objective To identify the existence of chromosome 9 open reading frame 72 (C9ORF72) intermediate hexanucleotide (GGGGCC) repeat expansions as well as the mutation-related clinical phenotypes in familial amyotrophic lateral sclerosis (fALS) population from mainland China.Methods DNA samples and clinical data of 62 fALS cases were collected,then the pathological GGGGCC repeat expansions were detected.Haplotype analysis for 20 single nucleotide polymorphisms (SNPs) was performed finally.Results The C9ORF72 intermediate repeat expansions were found in one fALS patient (1.61％,1/62),and repeat number was 24.In addition,2 siblings of this fALS patient also had a 24 repeats allele.These 24 repeat alleles were associated with the pathogenic founder haplotype.Conclusions This study illustrates the existence of the C9ORF72 intermediate repeat expansions in fALS population from mainland China for the first time.An intermediate repeat length in C9ORF72 is related to fALS in mainland China.

Objective To summarize the successful experience of radiodiagnosis specialist nursing model in our hospital.Methods Retrospectively analyze the course of establishment and development of radiodiagnosis specialist nursing model in our hospital.Many aspects including setting of the nursing unit,post,quota and salary,development of post responsibilities,systems,standards and procedures,establishment of quality control and performance evaluation system,standardization of the conventional specialist technology,study and application of the new specialist technology were expounded.Results Radiodiagnosis specialist nursing model had been established and improved after five years' exploration.Quality index of care,service and safety showed a steady upward trend.Specialist new technologies had prominent features.Teaching and research achieved initial success.Conclusions Establishment of radiodiagnosis specialist nursing model makes radiology nursing connotation more comprehensive.More importantly,it is of significance in guiding the development of radiodiagnosis specialist nursing.

Objective To study the separation ability of AB-8 macroporous resin in the purification of arctinin in Fructus arctii. Methods HPLC was used to measure the content of arctinin, and the adsorption performance and the elution parameters were investigated. Results The optimal separation conditions were as follows: the concentration of Arctinin was 5.5 mg/ml with a flow rate of 2 BV/h, and 50% alcohol was used as eluant. The adsorption of Arctinin was 52.08 mg/g, and the elution ratio of arctinin was 93.8%, and the purity of arctinin reached 65.2%. Conclusion AB-8 resin can be used to refine the arctinin in the extraction of Fructus arctii.

Objective To investigate the distribution and drug resistance of the gram positive bacteria isolates from hospital in Chongqing during 2006-2011 .Methods Non-repetitive gram positive bacterias were collected retrospectively from ten hospitals in Chongqing .Antimicrobial susceptibility testing of all clinical isolates were carried out using Kirby-Bauer(KB) .Results 14 473 strains were isolated .There were 4 840 strains of Staphylococcus aureus (33 .4% ) ,2 566 strains of Staphylococcus epidermidis (17 .7% ) ,1 822 strains of Staphylococcus haemolyticus (12 .6% ) ,1 325 strains of Enterococcus (E .faecalis/E .faecium )(9 .2% ) . Staphylococcus was highly sensitive to nitrofurantoin ,rifampicin ,piperacillin/tazobactam ,linezolid ,teicoplanin and vancomycin ,but their resistance rate to ampicillin/sulbactam ,oxacillin ,penicillin and clarithromycin was high .The resistance rate of E .faecium to the majority of antimicrobial agents was obviously higher than that of E .faecalis ,excluding imipenem ,chloramphenicol and tetracy-cline .Vancomycin and linezolid still remain the strongest antibacterial activity to Enterococcus .Conclusion The distribution and drug resistance of pathogenic bacteria in Chongqing present regional particularity ,and antibiotic resistance is severe .It is significant to strengthen the epidemiology study of pathogenic bacteria and to develop policies to intervene in the use of antimicrobial agents .