Objective:To summarize the combined rehabilitation nursing process of a case of voice and deglutition disorders following surgical removal of intra-and extracranial schwannoma in the jugular foramen area.Methods:A case of hoarseness and dysphagia after surgery for intracranial and extracranial schwannomas in the left jugular foramen region in Xuanwu Hospital, Capital Medical University in October 2020 was collected. Early step-wise voice training assisted by respiratory muscles and tongue muscle exercises was carried out, electronic laryngoscope-based breathing and swallowing methods, assessment of food and bite-size, maintenance of food consistency with the assistance of chewing times, and swallowing and ingestion guidance for the update of dietary methods were performed. The continuous rehabilitation training was provided throughout the process.Results:The grade of GRBAS scale decreased from G3 to G2 after training from home for 3 months following discharge; the voice handicap index of Chinese version reduced from 75 points to 52 points, and the average pronunciation time extended from 2.45 s to 5.32 s. The frequency of choking with food optimized from 0.4 to 0.5 times/min to no choking.Conclusions:Early rehabilitation training of voice and, swallowing and ingestion is a boon for the recovery of hoarseness and dysphagia after resection of schwannomas in the jugular foramen region.

This work was aimed to establish a quality control method for evaluating the effects on glucose and lipids of the fruiting body of Isaria cicadae Miquel from strain Ic-17-7 (Ic-17-7fb) using a rat model of type 2 diabetes (T2DM). Random amplified polymorphic DNA, sequence-characterized amplified region, and high-performance liquid chromatography (HPLC) were used for the quality control of Ic-17-7fb. The pharmacological effects on streptozocin (STZ)-induced high fat diet (HFD)-fed Albino Wistar rats were evaluated. The rats underwent the following treatments: control, metformin, Ic-17-7fb (0.166 and 0.5 g·kg
Animals ; Blood Glucose ; Cordyceps ; Diabetes Mellitus, Type 2/drug therapy* ; Metformin ; Quality Control ; Rats ; Rats, Wistar

Objective To investigate the factors affecting the efficacy of leflunomide combined with medium/low dose corticosteroids in the treatment of progressive IgA nephropathy (IgAN).Methods Clinical and pathological parameters were collected retrospectively in patients of primary IgAN with proteinuria＞ 1.0 g/24 h and chronic kidney disease (CKD) stage 1-3 treated with leflunomide combined with medium/low dose corticosteroids in Ren Ji Hospital,School of Medicine,Shanghai Jiao Tong University from Jan 2005 to Dec 2010.According to the treatment effects,patients were divided into complete remission group and non-complete remission group.The biochemical and pathological indexes of the two groups were compared.Results A total of 42 patients were included.The remission rates at 3,6,9 and 12 months were 62％,64％,67％ and 74％,respectively.Seventeen (40.5％) and fourteen (33.3％) patients achieved complete and partial remission after one-year treatment,and the remission rate remained stable within one year after withdrawal of drugs.The 24hour proteinuria was 1.50 (0.67,2.66) g,which was significantly reduced compared with the baseline 2.44 (1.36,3.74) g (P ＜ 0.01).The decrease rate was 31.3％.There was a slight decrease in proteinuriawithin one year after withdrawal of drugs.Estimated glomerular filtration rate (eGFR) remained stable during the treatment and a year of follow-up.No serious adverse event was observed during the followup period.Among 31 responder patients,6(19.4％) patients relapsed.Logistic multivariate regression analysis suggested that the degree of renal interstitial inflammatory infiltration was an independent predictor of complete remission with one-year treatment of leflunomide combined with medium / low dose corticosteroids (HR=0.067,95％ CI 0.008-0.535,P=0.011).Conclusions IgAN treated with leflunomide and medium/low dose corticosteroids can achieve remission in early stage,and the remission rate remains stable after withdrawal of drugs.It is a safe option for the treatment of IgAN.Renal interstitial inflammatory infiltration is an independent predictor of complete remission.

Objective To compare the efficacy and safety of leflunomide (LEF) combined with medium/low dose corticosteroids and full dose of corticosteroids in the treatment of IgA nephropathy. Method Primary IgAN patients diagnosed by renal biopsy with 18?65 years old and eGFR≥30 ml·min?1·(1.73 m2)?1 and proteinuria>0.5 g/24 h were enrolled in a prospective controlled clinical study. They were randomly divided into leflunomide combined with medium/low dose corticosteroids (LEF group) and corticosteroids alone (steroid group). The primary outcomes were (1) end stage renal disease or dialysis (2) 50% increase in serum creatinine above the baseline. Secondary outcome was the remission of proteinuria. Results Ninety patients completed the follow?up. The 24?hour proteinuria at baseline were 2.00(1.10, 2.88) g and 1.87(1.13 ,3.08) g in LEF group and steroid group respectively. Compared with baseline, it was significantly decreased in both groups at 6 months [0.30(0.11, 0.93) g, 0.30(0.14, 1.33) g] and 12 months [0.30(0.09, 0.82) g, 0.32(0.14, 0.66) g], (P<0.05). Estimated glomerular filtration rate (eGFR) at baseline, 6 months and 12 months were (80.39 ± 28.56), (87.12±28.70) and (88.20±30.26) ml·min-1·(1.73 m2)-1. It was decreased in steroid group (P<0.05), while no significant difference was detected in LEF group[baseline (87.63 ± 27.35), 6 months (86.91 ± 32.45), 12 months (90.06 ± 30.00) ml·min-1·(1.73 m2)-1, P>0.05]. At 6 and 12 months, there was no significant difference in terms of 24?hour proteinuria, serum creatinine and eGFR (CKD?EPI) between groups (P>0.05). There was no statistically significant difference in adverse events between groups during the treatment (9/40 cases in LEF group and 11/50 cases in steroid group, P>0.05). The average follow?up was 79 months, and there was no difference in the renal prognosis between the two groups. Multivariate Cox regression analysis revealed that serum creatinine at baseline and renal interstitial inflammatory cell infiltration predicted the risk of the progress of IgA nephropathy. Conclusion Leflunomide plus medium/low dose corticosteroids has a similar effect as full dose of corticosteroids in IgA nephropathy and does not increase the risk for adverse events during the treatment.

BACKGROUNDMitochondrial dysfunction is linked to the pathogenesis of Parkinson's disease (PD). However, the precise role of mitochondrial DNA (mtDNA) variations is obscure. On the other hand, mtDNA haplogroups have been inconsistently reported to modify the risk of PD among different population. Here, we try to explore the relationship between mtDNA haplogroups and sporadic PD in a Han Chinese population.

METHODSNine single-nucleotide polymorphisms, which define the major Asian mtDNA haplogroups (A, B, C, D, F, G), were detected via polymerase chain reaction-restriction fragment length polymorphism or denaturing polyacrylamide gel electrophoresis in 279 sporadic PD patients and 510 matched controls of Han population.

RESULTSOverall, the distribution of mtDNA haplogroups did not show any significant differences between patients and controls. However, after stratification by age at onset, the frequency of haplogroup B was significantly lower in patients with early-onset PD (EOPD) compared to the controls (odds ratio [OR] =0.225, 95% confidence interval [CI]: 0.082-0.619, P = 0.004), while other haplogroups did not show significant differences. After stratification by age at examination, among subjects younger than 50 years of age: Haplogroup B also showed a lower frequency in PD cases (OR = 0.146, 95% CI: 0.030-0.715, P = 0.018) while haplogroup D presented a higher risk of PD (OR = 3.579, 95% CI: 1.112-11.523, P = 0.033), other haplogroups also did not show significant differences in the group.

CONCLUSIONSOur study indicates that haplogroup B might confer a lower risk for EOPD and people younger than 50 years in Han Chinese, while haplogroup D probably lead a higher risk of PD in people younger than 50 years of age. In brief, particular Asian mtDNA haplogroups likely play a role in the pathogenesis of PD among Han Chinese.

Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; genetics ; DNA, Mitochondrial ; genetics ; Female ; Genetic Predisposition to Disease ; genetics ; Haplotypes ; genetics ; Humans ; Male ; Middle Aged ; Parkinson Disease ; genetics ; Pedigree ; Polymorphism, Single Nucleotide ; genetics

Objective To establish a methodological study pattern of quantitative analysis of multi-components by single marker ( QAMS) , and examine its feasibility and technical applicability in the quality control of compound preparation of traditional Chinese medicine-Jinhoujian spray. Methods Gas chromatographic method ( GC) was used and naphthalene served as the internal standard. Menthol was used as the reference substance. The relative correlation factors ( RCF) of 1,8-Cineole, camphor and borneol to menthol were calculated and established to carry out QAMS.The accuracy of this method was confirmed by comparison of internal standard method. Results The reproducibility of relative correction factor was perfect. The two methods did not show significant difference in 10 bathes of samples. Conclusion The QAMS method is feasible, credible, and can be used to determine active ingredients in Jinhoujian spray.

ObjectiveTo investigate the outcome and risk factors for kidney involvement by analyzing 64 patients with anti-neutrophil cytoplasmic antibody(ANCA)-associated vasculitis.MethodsData analyzed including the demographic information,survival status,renal survival status and laboratory parameters such asserum albumin level,serum creatinine level,urinary protein excretion level,hematuria,high sensitivity C-reactive protein(CRP),ANCA titer,and the Birmingham vasculitis activity score (BVAS).Logistic regression analysis,Cox regression analysis and ROC curve were used to evaluate the risk factors of patients with renal involvement and all-event survival.ResultsTotally 64 patients were enrolled [24 females with the average age of (59.9±2.0) years] and followed up for a median of (38±16) months.The morality rate was 14％,and the prevalence of end stage renal disease was 39％.Compared with those who had better outcomes,patients who died or with end stage renal disease had higher serum creatinine level [ (624±246),(245±127 ) μ mol/L,respectively,t=7.17,P＝0.005 ] and erythrocyte sediment rate [ (112±24),(76±48) mm/1 h,respectively,t=3.74,P＜0.01 ],but lower serum albumin level [(294±31 ),(316±42) g/L,respectively,t=-2.27,P=0.01 ] and hemoglobin level [ (79±13),(99±33) g/L,respectively,t=-3.23,P＜0.01 ] at baseline.Logistic regression analysis found that serum creatinine level and erythrocyte sediment rate at baseline were associated with poor outcome and Cox regression analysis further confirmed this result[Scrβ=1.004,95％CI1.002～1.006,P＜0.01; ESR β=l.018,95％CI 1.000～1.037,P=0.046].ROC curve analysis showed that serum creatinine and erythrocyte sediment rate were predictors for AAV patients' prognosis and their AUC were 0.95 and 0.80,the sensitivity of these parameters was both 94％,and the specificity was 93％ and 70％respectively.ConclusionThe intensity of initial treatment should be based on disease severity and activity in order to improve the prognosis of those with ANCA-associated vasculitis with renal involvement.Increased serum creatinine and erythrocyte sediment rate may serve as predictors for poor prognosis in this patient cohort.

Objective To differentiate proteinuria due to non-diabetic renal diseases(NDRD)from that of diabetic nephropathy(DN)in type 2 diabetic patients,and to evaluate the prevalence of NDRD.Methods A retrospective analysis was performed on diabetic patients who had undergone renal biopsy between Jan 1,2003 and Dec 3 1,2006.The data including history of diabetes,cardiac color ultrasound,color Doppler ultrasound of the carotid artery,retinal changes,examination of ocular fundus,giomerular filtration rate,hepatic and renal function,lipid profile,blood glucose,HbA1c,and urine protein were collected.Results Among 46 patients,22 cases (47.8%)were distinctly diagnosed as diabetic nephropathy(DN),while the other 24(52.2%)as NDRD.Focal segmental glomeruloselerosis Was the most common lesion found in patients with NDRD.In DN group,the fasting blood glucose was higher than that of NDRD group,as well as ejection fraction,carotid plaque,and intimamedia thickness(IMT)showed significant differences between 2 groups.Patients with NDRD were less frequently associated with diabetic retinopathy.Diabetic retinopathy showed hiigh sensitivity(72.7%)and specificity (91.7%)in diagnosing DN.Conclusions Blood glucose,ejection fraction,carotid plaques and IMT,and retinopathy may be helpful in differential diagnosis of diabetic patients with overt proteinuria.Renal biopsy is an important step lo establish the diagnosis.

ObjectiveTo observe the influence of different dietary protein intake (DPI) on nitrogen balance and nutritional indices in peritoneal dialysis (PD) patients, and explore the minimal DPI to maintain nitrogen balance.MethodsThirty-four PD patients were randomly divided into group A, B and C with DPI as 1.2, 0.9 and 0.6 g·kg-1·d-1 respectively. All the patients admitted into our hospital and completed a 10-day assessment for nitrogen balance, as well as nutritional status including serum albumin (Alb), pre-albumin at baseline, the 7th and 10th day. ResultsThe DPI of group A, B and C was (1.18±0.05), (0.87±0.02), (0.66±0.03) g·kg-1·d-1, whose differences were significant (P<0.01). The dietary energy intake (DEI) was 129.29 (117.57-133.89), 111.71 (100.42-133.47), 146.86 (128.03-163.18) kJ·kg-1·d-1 respectively. Nitrogen balance was positive in group A, B, C [2.99 (2.15-4.72) g, 1.20(0.59-1.89) g, 0.24 (-0.87-1.27) g]. The BUN decreased at the 7th and 10th day (P<0.01) in group C. The BUN and phosphorus in group A increased, but without significant difference as compared to baseline. No significant differences of nutritional status were found among three groups throughout the trial. ConclusionMinimal DPI 0.65 g·kg-1·d-1 plus the supplement of protein loss in dialysate can maintain the nitrogen balance in peritoneal dialysis patients.

Objective To investigate the stroke occurrence of chronic kidney disease (CKD) and its related factors, especially the carotid atherosclerosis. Methods The data of stroke occurrence in 700 CKD patients hospitalized in Renji Hospital during 2007 were analyzed retrospectively. The incidences of stroke were compared among CKD [Ⅰ-Ⅱ, CKD Ⅲ-Ⅴ non-dialysis patients and dialysis patients. Carotid atherosclerosis of 409 CKD patients was examined by color Doppler ultrasound. The related factors were selected by Spearmnan correlation analysis and Logistic regression analysis. Results Of 700 CKD patients, 67 cases (9.57%) experienced at least one episode of stroke, which was much higher than that of general population. The related factors of stroke in CKD included GFR, age, SBP, CRP, Lpa, serum glucose, pre-albumin, HDL and carotid atherosclerosis. Logistic regression revealed that SBP (β=1.021, P=0.042), CRP (β=1.008, P=0.024) and carotid atherosclerosis (β =3.456, P=0.025) were risk factors of stroke in CKD. Incidence of carotid atherosclerosis was high (50.37%) in CKD patients, besides it was significantly higher in CKD patients with stroke history as compared to those without stroke history (80.0% vs 47.4%, P<0.01). Conclusions The incidence of stroke is quite high in CKD patients, which is closely associated with hypertension, inflammation and glyeolipid metabolism disorder. Carotid atherosclerosis is common in CKD patients with stroke, which may be helpful in screening cerebrovascular diseases in CKD patients.