The prevalence of dementia in urban and rural areas of China

ObjectiveThe Chinese population has been aging rapidly and the country's economy has experienced exponential growth during the past three decades. The goal of this study was to estimate the changes in the prevalence of dementia, Alzheimer's disease (AD), and vascular dementia (VaD) among elderly Chinese individuals and to analyze differences between urban and rural areas.MethodsFor the years 2008 to 2009, we performed a population-based cross-sectional survey with a multistage cluster sampling design. Residents aged 65 years and older were drawn from 30 urban (n = 6096) and 45 rural (n = 4180) communities across China. Participants were assessed with a series of clinical examinations and neuropsychological measures. Dementia, AD, and VaD were diagnosed according to established criteria via standard diagnostic procedures.ResultsThe prevalence of dementia, AD, and VaD among individuals aged 65 years and older were 5.14% (95% CI, 4.71–5.57), 3.21% (95% CI, 2.87–3.55), and 1.50% (95% CI, 1.26–1.74), respectively. The prevalence of dementia was significantly higher in rural areas than in urban ones (6.05% vs. 4.40%, P < .001). The same regional difference was also seen for AD (4.25% vs. 2.44%, P < .001) but not for VaD (1.28% vs. 1.61%, P = .166). The difference in AD was not evident when the sample was stratified by educational level. Moreover, the risk factors for AD and VaD differed for urban and rural populations.ConclusionsA notably higher prevalence of dementia and AD was found in rural areas than in urban ones, and education might be an important reason for the urban–rural differences.     

Acute and sub-chronic toxicity studies of the extract of Thunberg Fritillary Bulb

The aim of this study was to investigate the acute and sub-chronic toxicity of extract of Thunberg Fritillary Bulb. For the acute toxicity tests, graded doses of the extract were administered orally to mice. The animals were observed for toxic symptoms and mortality daily for 14 days. In the sub-chronic toxicity study, rats were orally administered the extract at doses of 1 and 3 mg/kg body weight (BW) for 26 weeks. After 26 weeks, the rats were sacrificed for hematological, biochemical and histological examination. In the acute toxicity tests, the estimated median lethal dosage (LD₅₀) was 52.2 mg/kg body weight in the mice. In the sub-chronic toxicity tests, a dose of 1 mg/kg body weight presented no toxicity. Above the 1 mg/kg dose, the main adverse signs observed in male rats were body or head tremor and spontaneous motor activity reduction. There were no other significant changes observed in hematology, blood biochemistry, organ weight and organ histology. The overall findings of this study indicate that the extract of Thunberg Fritillary Bulb is non-toxic up to 1 mg/kg body weight, which can be considered a safe application dose.     

Parathyroid conditions in childhood

This review of parathyroid surgery in children will briefly discuss parathyroid gland embryology and anatomy before focusing on the pathophysiology, clinical presentation, and treatment of hyperparathyroidism in children. Hyperparathyroidism (HPT) is the overproduction of PTH and it is rare in children, with an incidence of 2-5 per 100,000. This rarity means that the principles of caring for children with parathyroid disease are largely extrapolated from the richer adult experience; however, the unique pediatric aspects of parathyroid problems and their surgical treatment, including presentation, imaging, operative approach, and complications, will be considered.     

二氧化钚对免疫功能的影响——大鼠气管内注入后白细胞移行制作用的研究

本文介绍了气管内注入²³⁹PuO₂后Wistar大鼠免疫功能的变化,注入剂量为5.25μCi,CMD为2.5。于中毒后第7、14、21和30天采血样,以毛细管法作白细胞抑制试验(MIT),每个样品分成加PHA组和未加PHA组,未中毒组加PHA后游走抑制明显,移动抑制指数(MII)小于0.8,这表明机体细胞免疫功能正常。中毒组于中毒后第14、21和30天游走抑制能力下降。MII大于或等于0.8,这说明机体内细胞免疫功能有所下降。结果提示²³⁹PuO₂吸入中毒后可影响机体的细胞免疫状态。     

Prospective Phase II Study of the Efficacy of Transcutaneous Electrical Nerve Stimulation in Post-radiation Patients

AimsTo evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) delivered using an extra-oral device in patients with radiation-induced xerostomia.Materials and methodsThirty oral cavity and oropharyngeal cancer patients post-adjuvant (n = 26) or definitive radiotherapy (n = 4) were enrolled in this study. The TENS electrode pads were placed externally on the skin overlying the parotid glands. Unstimulated whole saliva was collected for 5 min into graduated tubes using the low forced spitting method. The TENS unit was then activated and stimulated saliva was collected for an additional 5 min. The difference between unstimulated and stimulated saliva output was measured using the paired t-test. Linear regression was used to determine factors significantly influencing the improvement in salivary output.ResultsTwenty-nine of 30 patients showed increased saliva flow during stimulation. A statistically significant improvement in saliva production (P < 0.05) during stimulation was noted. The mean unstimulated saliva flow was 0.056 ml/min and the mean stimulated saliva flow was 0.12 ml/min with a median increase of 0.06 ml/min. The interval to the application of TENS after radiotherapy significantly influenced the improvement in salivary flow.ConclusionExtra-oral application of TENS is effective in increasing the whole salivary flow in most of the post-radiated oral cavity/oropharyngeal cancer patients with xerostomia. TENS therapy may be useful as an effective supportive treatment modality in post-radiated oral cancer patients.     

Four-Year Impact of Voiding and Storage Symptoms in Patients with Benign Prostatic Hyperplasia Treated with Prostatic Artery Embolization

PurposeTo study the subscore improvement in International Prostate Symptom Scores (IPSS) after prostatic artery embolization (PAE).Materials and MethodsA single-center retrospective study was carried out with follow-up from December 2013 to July 2019 in 37 consecutive patients (66.0 ± 8.8 years old) who underwent PAE, comparing resultant scores before and after PAE. IPSS were divided into storage (IPSS-s) subscores and voiding (IPSS-v) subscores. The changes between IPSS-s and IPSS-v at 1, 3, 6, and 12 months’ follow-up as well as the last follow-up were compared with baseline scores. The changes in percentages of IPSS-s and IPSS-v and the changes in average IPSS-s-to-total IPSS ratios (IPSS-s/IPSS-t) and IPSS-v-to-IPSS-t ratios (IPSS-v/IPSS-t) were also analyzed.ResultsIn the study population, consisting of 37 patients, IPSS-t significantly decreased from 16.5 ± 7.2 at baseline to 8.3 ± 5.7 at the last follow-up (4 years later) (P < .0001). Additionally, the changes in IPSS-v symptoms were greater than the changes in IPSS-s symptoms at 1, 3, 6, and 12 months’ follow-up, reaching a statistical significance at 6 months with a decrease of 72.9% ± 42.4% for IPSS-v and a decrease of 50.1% ± 52.2% for IPSS-s (P = .009).ConclusionsPAE can successfully reduce both IPSS-s and IPSS-v with predominant IPSS-v reduction. The improvements in both subscores were sustained for up to 4 years of follow-up.     

A colorectal mosaic pattern might be an endoscopic feature of collagenous colitis

Background and aimsThe endoscopic aspect of the colorectal mucosa in those patients with collagenous colitis is usually normal, or with non-specific changes. Until now it had never been related to a mucosal pattern of mosaic type. Our aim was to determine the diagnostic accuracy of the presence of mosaic pattern in the colorectal mucosa for collagenous colitis.MethodsPatients who had undergone a colonoscopy with random biopsies performed in the diagnostic evaluation of chronic diarrhea between 2004 and 2008 were studied. We defined patients with chronic diarrhea and mosaic mucosal pattern as “cases”, and patients with chronic diarrhea without mosaic pattern as “controls”. The odds ratio (OR) of finding a collagenous colitis in view of a mosaic pattern in colon was determined; as well as sensitivity and specificity; positive and negative likelihood ratios (LR+, LR?), considering this finding as a diagnostic instrument for collagenous colitis.Results252 patients who had undergone colonoscopý with biopsy due to chronic diarrhea were analyzed. In 6 patients, a mosaic pattern was identified in the colorectal mucosa. The histological diagnose of 36 of the 252 patients (14%) was microscopic colitis, 27 of which (11%) had collagenous colitis. The colonoscopy was found normal in 21 of these 27 patients; in 2 patients, congestion or petechiae was found in the rectum; and in 4 patients (15%), all women, a mosaic pattern was found in the rectosigmoid mucosa. The OR of this finding was 19.4 (CI95% 3.9–95.4) for collagenous colitis. It had a sensitivity of 14.8% (CI95% 6.8–20), a specificity of 99.1% (CI95% 98.2–99.7), LR+ of 16.6 (CI95% 3.7–76.4), and LR? of 0.86 (CI95% 0.80–0.95) for a collagenous colitis.ConclusionThe mosaic pattern in the colorectal mucosa of patients studied due to chronic diarrhea could be a distinguishing feature of collagenous colitis.     

Does intestinal translocation of bacteria affect the short,intermediate or long-term mortality of patients undergoing laparotomy?

%Bacterial translocation has been shown to occur in surgical patients and although its significance is uncertain, it may have a role in the causation of sepsis. There is considerable controversy about the effect of translocation on postoperative mortality because the available evidence is contradictory.The aim of this study was to investigate the effect of bacterial translocation on early, intermediate and late mortality in patients undergoing laparotomy.Our results showed that in a series of 495 patients, bacterial translocation occurred in 86 (17%). The number of deaths in translocators and non-translocators was 36 and 144 respectively (χ² = 1.30, p = 0.25). Trends in Kaplan-Meir curves suggested that survival in translocators was lower than in non-translocators but these trends were not significant in the short (p = 0.14) intermediate (p = 0.15) or long term (p = 0.24, log-rank test).From the analysis of our results we concluded that bacterial translocation is a common occurrence in surgical patients but it does not have an adverse effect on postoperative mortality.