Objective:To summarize and compare the characteristics of orthostatic hypotension (OH)　in　patients　with　Parkinson′s disease and multiple system atrophy (MSA).Methods:The active standing test data of 210 Parkinson′s disease patients (Parkinson′s disease group) and 85 MSA patients (MSA group) admitted to the Department of Neurology, Xuanwu Hospital, Capital Medical University from January 2021 to March 2022 were retrospectively analyzed. Demographic information, clinical data, Hoehn-Yahr staging, and Unified Parkinson′s Disease Rating Scale (UPDRS), Non-Motor Symptoms Questionnaire (NMSQ), Montreal Cognitive Assessment Scale and Mini-Mental State Examination scores were collected. The comparative analysis of OH was conducted according to the changes of heart rate and blood pressure during the active standing test.Results:Among the 85 patients with MSA, 52 were found with MSA parkinsonism variant (MSA-P) and 33 with MSA cerebellar variant (MSA-C). The 210 Parkinson′s disease patients were aged (61.5±11.0) years, with 116 males (55.2%). The 85　MSA　patients　were aged (60.1±6.8) years, with 44 males (51.8%). Compared with the Parkinson′s disease group, the Hoehn-Yahr staging [2.0(2.0, 3.0) vs 3.0(2.0, 3.0), Z=-5.278, P<0.001], NMSQ[ 25.0(11.0,46.5) vs 45.0(24.0,70.0), Z=-3.632, P<0.001] and UPDRS scores [50.0(32.0,68.0) vs 65.5(44.5,78.5), Z=-3.073, P=0.003] in the MSA group were higher. The incidence of OH in the MSA group was higher than that in the Parkinson′s disease group [63.5% (54/85) vs 25.7%(54/210), χ 2= 37.284, P<0.001], but there was no statistically significant difference between the MSA-P and MSA-C groups . Compared with the Parkinson′s disease group, the MSA group had a higher incidence of classical OH [54.1%(46/85) vs 12.9%(27/210), χ 2=55.316, P<0.001] and neurogenic OH [36.5%(31/85) vs 9.0%(19/210), χ 2=32.326, P<0.001],but there was no statistically significant difference in the incidence of initial OH and delayed OH between the two groups. The incidence of severe OH in the MSA group was also higher than that in the Parkinson′s disease group [57.6%(49/85) vs 16.7%(35/210), χ 2=49.894, P<0.001], but there was no statistically significant difference in the incidence of pre-clinical OH and mild OH between the two groups. Conclusions:The incidence, time change, severity and pathophysiological basis of OH in Parkinson′s disease and MSA patients are different. Different types of OH may help to distinguish MSA from Parkinson′s disease.

OBJECTIVE To establish the fingerprint of the Zhuang medicine preparation Fuzheng capsules and a method for the determination of multi-ingredient content for quality evaluation. METHODS High-performance liquid chromatography （HPLC） was used in conjunction with the Similarity Evaluation System for Chromatographic Fingerprints of Traditional Chinese Medicine （2004A edition） to establish the fingerprint of 12 batches of Fuzheng capsules， evaluate their similarity and confirm the common peaks. Cluster analysis and principal component analysis were performed using SPSS 20.0 software with the peak areas of the common peaks in the fingerprint as variables. The same HPLC method was adopted to determine the content of liquiritin， specnuezhenide， 3，6′-disinapoyl sucrose and ammonium glycyrrhizinate in the 12 batches of samples. RESULTS A total of 22 common peaks were identified in the fingerprints of the 12 batches of Fuzheng capsules， with the similarities greater than 0.91. Four common peaks were identified as liquiritin （peak 8）， specnuezhenide （peak 10）， 3，6′-disinapoyl sucrose （peak 11）， and ammonium glycyrrhizinate （peak 21）. The 12 batches of samples could be clustered into 3 categories， with 200801， 200802 and 200803 as category Ⅰ， samples 1 to 8 as category ， and 221101 as category Ⅲ. The sample 200802 had the highest comprehensive score （2.540）. The contents of liquiritin， specnuezhenide， 3，6′-disinapoyl sucrose and ammonium glycyrrhizinate in the 12 batches of samples were 0.44 to 0.73， 1.28 to 2.47， 0.08 to 0.12， and 1.31 to 1.81 mg per capsule， respectively. CONCLUSIONS The main components of the 12 batches of Fuzheng capsules were similar， but the content varied， with the sample 200802 indicating the highest quality. The established fingerprint and multi-ingredient content determination method were highly specific and accurate， which can be used for the quality evaluation of Fuzheng capsules in combination with chemical pattern recognition analysis.

Objective:To investigate the normal reference values of spinal bone mineral density measured by quantitative computed tomography (QCT) and the differences of bone mineral density (BMD) in different regions of in Chinese adult males.Methods:Men who underwent low-dose CT lung scan for cancer screening in regions of Northeast, North, East, South, Central and Southwest of China from January 2018 to December 2019 were selected. And the lumbar vertebrae BMD values in the male subjects were measured by the QCT system (Mindways Software, Inc.). The mean BMD values and their decline rates were calculated at an age interval of 10 years, and the prevalence of osteoporosis was calculated according to the American College of Radiology spine QCT osteoporosis diagnostic criteria.Results:A total of 50 682 males with a mean age of (50.22±12.79) years (ranged 20 to 98 years) were included in this study. The peak BMD of (173.11±28.56) mg/cm 3 in the healthy Chinese adult male population appeared in the age group of 20 to 29 years and then declined with age. Before the age of 70 years, the BMD was relatively higher in males in South China, and it was lower in Central China and Southwest China, and it was intermediate in Northeast, North and East of China, with statistically significant differences. There was no significant differences in BMD in the males in the two age groups of 70 to 79 years and 80 and older among the regions in China. The overall decline rate of spinal BMD in Chinese males under QCT was about 46.92% over the lifetime, and it declined obviouslyin the 40-49 age group. The overall prevalence of osteoporosis in Chinese male population aged 50 years and above was approximately 11.42%, with the highest prevalence in Southwest China and Central China (14.72% and 13.87%, respectively) and the lowest in North China and South China (8.53% and 7.71%, respectively). Conclusions:A reference of lumbar spine BMD values for healthy males in China based on QCT is established. BMD values were highest in South China and Lowest in Central China.

Objectives To investigate the efficacy and safety of quadruple regimen containing doxycy-cline,amoxicillin and clavulanate potassium in the treatment of Helicobacter pylori(Hp)after the failed initial eradication. Methods A total of 136 patients who had a failed course of initial eradication therapy were randomly divided into four groups. The 46 patients in group A were given rabeprazole,colloidal bismuth tartrate,doxycy-cline,amoxicillin and clavulanate potassium for 14 days). The 45 cases in group B were treated with rabeprazole, colloidal bismuth tartrate,doxycycline,amoxicillin and clavulanate potassium for 10 days. The 45 cases in control group received rabeprazole,colloidal bismuth tartrate,levofloxacin,amoxicillin for 14 days. After 4 weeks of treat-ment,the 13C-urea breath test was performed. The Hp eradication rates,adverse reactions,treatment compliance and cost-effectiveness ratio of the three groups were evaluated. Results A total of 130 patients completed the study. The intention to treat(ITT)and Per-protocol(PP)analyses revealed that the eradication rates of the three groups were 71.74% and 76.74%(group A),71.11% and 72.72%(group B),51.11% and 53.49%(control group),respectively. The ITT and PP of group were significantly higher than those of control group(P < 0.05). But there was no significant difference between group B and control group(P > 0.05). The rates of adverse reac-tions in each group were not statistically significant(P > 0.05),and the patient compliance of three groups was more than 80%. The cost and cost-effectiveness ratio showed that group B < control group < group A. Conclu-sions The quadruple therapy containing doxycycline,amoxicillin and clavulanate potassium as a rescue regimen given for 14 days is safe,effective and with high patient compliance,which is of high clinical significance.

Objective To explore the value of miniprobe sonography (MPS) in differentiating Crohn??s disease (CD) and ulcerative colitis (UC). Methods 46 patients with active inflammatory bowel disease (IBD) were included into the patient group (16 patients with CD and 30 cases with UC). 20 healthy cases ( underwent physical examination in outpatient department) were recruited as the control group. All cases underwent MPS and high sensitive C-reactive protein (Hs-CRP) test.The MPS measurement index include thetotalwallthickness(TWT), mucosal thickness (MT), submucosal thickness (SMT), muscularispropria thickness (MPT), and the number of enlarged colic and paracolic lymph nodes. Results TheTWT, M, SM, MP(mm)and Hs-CRP(mg/L)in CD, UC and control group are 5.84 ± 1.42, 1.48 ± 0.23, 1.88 ± 0.28, 2.31 ± 0.85, 40.58 ± 19.33, 4.74 ± 1.01, 1.79 ± 0.35, 1.41 ± 0.25, 1.32 ± 0.34, 22.41 ± 15.25,2.86 ± 0.23, 0.97 ± 0.13, 1.06 ± 0.11, 0.64 ± 0.0 and 1.70 ± 0.65. TWT, MT, SMT, MPT and Hs-CRP in UC group has significant different with those in controp group(P<0.05). The mean value of TWT, MT, SMT, MPT and Hs-CRP in CD group are higher than those in UC group. M in UC group is higher than that in CE group. The difference is significant(P<0.05). 5 cases in CD and 2 cases with UC had enlarged colic or paracolic lymph nodes. Conclusions The MPS can distinctly observe the changesof different colonic tissue layers and the surrounding tissue structures in IBD patients,which helps for distinguishing active CD from UC.

Objective To investigate the protective effects of dexmedetomidine on lung injury during one lung ventilation in patients undergoing lobectomia pulmonalis.Methods Sixty-four patients undergoing lobectomy in our hospital from May 2014 to February 2017 were selected.There were 38 males and 26 females,aged 42-75 years,ASA physical status Ⅱ or Ⅲ.Patients were divided into two groups according to different treatments,n=32 in each group.The patients in the observation group were given dexmedetomidine 0.5 μg· kg-1 · h-1 at 20 min before the induction of anesthesia,and adjusted to 0.2-0.5 μg·kg-1 ·h-1 after 10 min.The control group was given equal volume normal saline.The changes of polymorphonuclear neutrophil (PMN),myeloper oxidase (MPO),intra-pulmonary shunt rate(Qs/Qt),xanthine oxidase (XOD),vascular endothelial growth factor (VEGF) and nitric oxide (NO) concent ration were recorded at 10 min before induction (T0),beginning of OLV (T1),OLV for 60 min (T2),90 min (T3),postoperative 24 h (T4).Results Compared with T0,the PMN counts increased significantly at T2-T4 and the serum MPO and XOD concentrations were significantly increased (P＜0.05).The PMN counts,serum MPO and XOD concentration in the observation group were significantly lower than those in the control group (P＜0.05).Compared with T0,the serum VEGF concentration was significantly increased at T2 and T3,and the serum VEGF concentration in the observation group was significantly lower than that in control group at T3 (P＜0.05).The serum NO concentration at T2 and T3 in observation group was significantly higher than that in control group (P＜0.05).Conclusion Dexmedetomidine can reduce the inflammatory response of the lungs and has a protective effect on ischemia-reperfusion and injury in patients with single lung ventilation,and reduce the degree of oxidative stress,which plays a protective effect on lung.

BACKGROUNDWe evaluated the impact of the number of metastatic lymph nodes and the metastatic lymph nodes ratio (the ratio between metastatic lymph nodes and total dissected lymph nodes, MLNR) in patients with gastric adenocarcinoma following curative gastrectomy and also analyzed the relationship between the number of removed lymph nodes and prognosis in node-negative gastric cancer.

METHODSFrom January 2005 to December 2010, 1 390 patients who were diagnosed with gastric adenocarcinoma and underwent curative gastrectomy were included. In particular, lymph node metastasis was not present in 515 patients. The number of metastatic lymph nodes and the metastatic lymph nodes ratio were selected for univariate and multivariate analyses to evaluate their influences on the disease outcome. The survival curve was presented according to the number of removed lymph nodes in node-negative gastric cancer using Kaplan-Meier plots.

RESULTSThe overall 5-year survival rate was 54% in this group. Univariate analysis revealed that age category, macroscopic appearance, histological grade, tumor size, depth of primary tumor invasion, number of metastatic lymph nodes, metastatic lymph nodes ratio, tumor, nodes, metastasis-classification (TNM) stage and status of lymphovascular, and vessel invasion have significant impact on survival. The number of metastatic lymph nodes and the metastatic lymph nodes ratio both have significant impact on survival (P < 0.001). However, in multivariate analyses, only the metastatic lymph nodes ratio was identified to be an independent prognostic factor (P < 0.001). The number of removed lymph nodes in node-negative was a strong prognostic factor of survival, the more lymph nodes dissected, the better the survival.

CONCLUSIONSThe metastatic lymph nodes ratio has more significant prognostic value for survival in patients with gastric cancer following curative gastrectomy than the number of metastatic lymph nodes. The number of removed lymph nodes might be an important prognostic factor for gastric cancer without lymph node metastasis.

Adenocarcinoma ; mortality ; surgery ; Aged ; Female ; Gastrectomy ; Humans ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Stomach Neoplasms ; mortality ; surgery

Objective To explore the effects of combined infusion of Treg cells from recipient rats and imDCs from donor rats prolonging the survival time of rats undergoing allogeneic orthotopic liver transplantation.Methods One hundred cases of rat allogeneic orthotopic liver transplantation were performed by using modified two-cuff method: DA rats served as donors,and Lewis rats as recipients,which were divided into 5 groups: acute rejection group,mDC group,imDC group,Treg group,co-infusion group (imDC-Treg group).2 × 106 imDC,2 × 106 mDC and 1 × 107 Treg cells were respectively injected to Lewis rats in every group via caudal vein before transplantation.Four Lewis rats from each group were randomly sacrificed on the day 3,7 and 10 after transplantation.Liver function (ALT and TBIL) and changes of cytokines (IL-10,IL-2 and TGF-β) were evaluated in peripheral blood.The pathological changes of the liver graft were observed.The DNA fragmentation characteristics of apoptosis in the liver were detected by using TUNEL staining.Survival analysis was performed on remnant rats.Results The liver function in imDC-Treg group had reverted to normal faster than that in the control groups.ELISA revealed that at day 7,the serum levels of IL-10 and TGF-β were higher,and the serum levels of IL-2 were lower in imDC-Treg group.Liver pathology demonstrated that there was only a slight number of mononuclear cell infiltration in hepatic graft afterorthotopic liver transplantation in co-infusion group (imDC-Treg group),which belonged to a nonidentified or slight type of acute rejection,and the liver graft showed regeneration of hepatocytes along with a small number of neutrophile granulocyte infiltration at the day 10.TUNEL staining indicated that the number of apoptotic T cells was much less in control groups than in imDC-Treg groups.The survival time of recipients in Treg-imDC group was 37 days,significantly longer than in irnDC group (23 days) and Treg group (15 days).Conclusion Infusion of imDC from donor rats or Treg from recipient rats alone couldn't induce long-term allograft survival of recipients after allogeneic rat liver transplantation.The co-infusion of Treg and imDC significantly prolonged the survival time of rats subject to allogeneic liver transplantation.

Objective To evaluate the application of echocardiography in the diagnosis of bicuspid aortic valve and its pathophysiologic development and to demonstrate the degree of aortic valve dysfunction. Methods The echocardiographic characteristics and clinical data were analyzed retrospectively in 135 patients with bicuspid aortic valve to demonstrate the variation of aortic valve dysfunction in the progression of the course of the disease. Results Isolated aortic regurgitation was present in 68 (50%) patients, 19 (14%)patients had isolated aortic stenosis and 29 (22%)patients had combined aortic stenosis and regurgitation, 19 (14%) patients had neither stenosis nor regurgitation. Aortic regurgitation were all more commen within each age group, aortic regurgitation were also more commen within each age group in patients in their advanced course who went to surgical treatment. Conclusions Echocardiography is an effective method in the early diagnosis of aortic valve dysfunction.

two-dimensional strain echocardiography can observe dynamic change of regional systolic function,combined with the two methods can more accurately assess the treatment results of coronary artery bypass surgery.