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 make a comprehensive evaluation of nano-composite of poly(L-lactide) and surface grafted hydroxyapatite(PLLA/PLLA-gHA) as a new material.Methods According to the evaluated critera of medical implanted materials biology and animal trial recommended in GB/T 16886 and IS0 10993 criterion,the new material was carried out on acute systemic toxicity test,haemolysis test,muscular implantation test and subcutaneous injection test.The extract liquid of new material was injected into mice by vena caudalis to test common station,toxic reaction of it at different time,the results were used to evaluate the acute systemic toxicity.Fresh anticoagulant cony blood was mixed with extract liquid of new material with density of 100 g?L-1 to measure each absorbance with spectrophotometer and work out the corresponding rate of haemolysis.The red punctuation and hydropsia of rabbits were observed at different time by subcuntaneous injecting extract liquid into the back of rabbits.PLLA/PLLA-gHA composite plates were implanted into the sacrospinal muscle of rabbits.Cony venous blood was extracted to detect indicatrix of hematology at diferrent time.The material and surrounded tissues were taken out from animals at the 14th,30th,60th,90th,180th,360th day to examine anatomic and pathological changes.Results Rabbits with PLLA/PLLA-gHA composite had good general condition.There was no any acute systemic toxicity in vivo.Data of AST and Scr had no significant difference between experimental group and control group.The hemolysis rate of extrac liquid was 1.22%,which was under the standard criteria(5%).No red punctuation and light hydropsia were observed at different time in the subcutaneous injection test.The inflammation cytochange of PLLA/PLLA-gHA composite group was similar with that of control group in early days,which was met with the general regularity of inflammatory outcome.The fibrosis membrane surrounding the PLLA/PLLA-gHA composite became thinner gradually with the elongation of implantation time.The fibrosis membrane grew into the material at the 360th day.The degree of the fibrosis membrane was below class Ⅰ.Conclusion The new absorbable type PLLA/PLLA-gHA composite has excellent biocompatibility and security.

Objective: To explore therapeutic effects of calcium channel blocker combined statins on aged patients with hypertension, and their influence on inflammatory factor levels.Methods: A total of 124 aged patients with hypertension, who were treated in our hospital from Oct 2014 to Oct 2015 , were randomly and equally divided into amlodipine group (received amlodipine therapy based on routine treatment) and combined treatment group (received atorvastatin calcium based on amlodipine group) according to random number table.Levels of blood pressure, C reactive protein (CRP), interleukin (IL)-6, endothelin (ET) and blood lipids before and after treatment, and therapeutic effect and incidence of adverse reactions were compared between two groups.Results: Compared with amlodipine group after treatment, there were significant reductions in levels of systolic blood pressure [(143.57±3.14) mmHg vs.(131.73±3.42) mmHg], diastolic blood pressure [(82.17±3.26) mmHg vs.(76.51±3.27) mmHg], CRP [(7.32±0.71) mg/L vs.(5.57±0.76) mg/L], IL-6 [(133.42±27.31) ng/L vs.(123.73±22.81) ng/L], ET [(50.74±4.96) pg/L vs.(45.71±5.78) pg/L], total cholesterol [(5.32±0.66) mmol/L vs.(4.12±0.52) mmol/L], triglyceride [(1.56±0.42)mmol/L vs.(1.21±0.37) mmol/L] and low density lipoprotein cholesterol [(3.12±0.48) mmol/L vs.(2.43±0.43) mmol/L], and significant rise in high density lipoprotein cholesterol level [(1.41±0.12) mmol/L vs.(1.55±0.17) mmol/L] in combined treatment group, P<0.05 or <0.01.Compared with amlodipine group, there was significant rise in total effective rate (77.4% vs.91.9%) in combined treatment group, P=0.025.There was no significant difference in incidence rate of adverse reactions between two groups (P>0.05).Conclusion: Calcium channel blocker combined statins possesses definite therapeutic effects on aged patients with hypertension.It can reduce levels of blood pressure and blood lipids and inflammations and improve vascular endothelial cell function, which is worth extending.

Objective To evaluate the diagnostic value of serum M-type phospholipase A2 receptor(PLA2R) antibody detection for the diagnosis of idiopathic membranous nephropathy(IMN) by meta analysis.Methods By searching the databases of PubMed,Emabse,Wanfang and CNKI from inception to May,2017,all the literatures referred to serum PLA2R antibody for the diagnosis of IMN in both English and Chinese were reviewed and selected according to the inclusion and exclusion criteria.QUADAS was used to assess the quality of eligible studies.Meta-disc 1.4 was used to analyze heterogeneity and pooled effectsize and Stata 12.0 was used to analyze publication bias.Results A total of 20 studies with high quality were included.Heterogeneity test indicated there was no threshold effect.The pooled sensitivity was 0.69 (95 ％ CI:0.67 to 0.72),the pooled specificity was 0.97 (95 ％ CI:0.96 to 0.98) and the summary area under curve was 0.880.Sensitivity analysis indicated that the result was stable.Deek's funnel plot indicated there was no publication bias.Conclusion The sensitivity of detection of serum PLA2R antibody was acceptable for the diagnosis of IMN with high specificity,so more attention on PLA2R antibody should be paid in the clinical practice.

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 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 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.