Parkinson's disease may reduce sensitivity to visual-tactile asynchrony irrespective of dopaminergic treatment: Evidence from the rubber hand illusion

BackgroundThe feeling of body ownership relies on the binding of multisensory body-related signals. Various sensory abnormalities have been described in Parkinson's disease (PD).ObjectiveTo assess the rubber hand illusion (RHI) in patients with PD (PwPD) and age-matched healthy controls (CTRL). To evaluate the influence of the dopaminergic system in a PwPD subgroup OFF medication.MethodsThe RHI paradigm was applied to 42 PwPD and 48 CTRL. In this experimental setup, stroking a visible plastic hand simultaneously with the covered real hand elicits the feeling of ownership over the seen hand. Asynchronous stroking served as a control condition. Proprioceptive bias and an illusion score based on a questionnaire were used as measures of the RHI. Seventeen PwPD additionally underwent the experiments “OFF medication”.ResultsCompared to CTRL, PwPD showed higher proprioceptive bias independent of the stroking condition (p = 0.015), and had higher illusion scores in the asynchronous condition (p < 0.05). In PwPD, there were no significant differences between ON- and OFF-medication state.ConclusionIn PwPD, responses to the RHI are less specific with respect to the degree of synchronicity of brushstrokes. This might be attributed to a less stable body representation, internal “noise” during multisensory integration, or a blur of temporal discrimination in PD. The fact that RHI measures did not differ between ON- and OFF-medication states indicates an involvement of non-dopaminergic transmitter systems in this finding.     

Peak C-reactive protein levels do not predict 30-day mortality for bacteremia: A retrospective cohort study

IntroductionAlthough peak C-reactive protein (CRP) levels are correlated with the prognosis of some diseases, there have been no reports regarding the association between peak CRP levels and mortality in patients with bacteremia. The present study aimed to determine the association between peak CRP levels and prognosis in patients with bacteremia.MethodsThis retrospective cohort study was conducted in a single tertiary hospital and included patients with bacteremia admitted to the emergency department from November 2012 to March 2017. Cox regression analysis was performed to examine the association between peak CRP levels and 30-day mortality. We also performed propensity score adjustment using potential confounding factors.ResultsOne hundred fifty-nine patients were included in the study. Peak CRP levels were significantly higher in the β-hemolytic streptococci (P = 0.001) and Streptococcus pneumoniae (P = 0.003) groups. The C-statistic of the multivariate logistic regression model for the propensity score was 0.88. For 30-day mortality, peak CRP levels >20 mg/dL did not show significance in the Cox regression analysis (hazard ratio, 0.866; 95% confidence interval, 0.489–1.537; P = 0.62). Even after propensity score adjustment, no significance was noted (hazard ratio, 0.865; 95% confidence interval, 0.399–1.876; P = 0.71).ConclusionsPeak CRP levels were not an independent predictor of mortality in patients with bacteremia in the emergency department. Clinicians should consider that patients with extremely high peak CRP levels do not necessarily have high mortality and vice versa.     

针灸治疗对脑卒中偏瘫患者总有效率的影响

目的:探究针灸治疗对脑卒中偏瘫患者总有效率的影响。方法:将2017年1月-2018年12月在我院接受治疗的58例脑卒中偏瘫患者作为研究对象,随机数字表法分为观察组与对照组,每组29例,分别给予针灸治疗与常规治疗,对两组患者治疗前后神经功能缺损评分(Neurological Impairment Score Scale,NIHSS)、日常生活能力(Barthel指数)以及临床治疗效果进行综合评价。结果:观察组患者治疗后的NIHSS评分明显降低,Barthel指数提高,与对照组比较差异有统计学意义(P<0.05);观察组患者治疗后总有效率与对照组比较,差异有统计学意义(P<0.05)。结论:针灸治疗脑卒中偏瘫患者,能够促进神经功能改善,提高患者日常生活能力,效果显著,值得推广应用。     

当归龙荟片联合普芦卡必利治疗慢性功能性便秘的临床研究

目的探讨当归龙荟片联合普芦卡必利治疗慢性功能性便秘的临床疗效。方法选取2018年5月-2019年5月在北京市肛肠医院治疗的慢性功能性便秘患者122例,根据用药的差别分为对照组(61例)和治疗组(61例)。对照组口服琥珀酸普芦卡必利片,2mg/次,1次/d;治疗组在对照组基础上口服当归龙荟片,4片/次,2次/d。两组患者均经4周治疗。观察两组患者临床疗效,同时比较治疗前后两组患者临床症状评分、PAC-QOL积分、结肠传输试验积分、Bristol和SF-36评分,及血清5-羟色胺(5-HT)、血管活性肠肽(VIP)、P物质(SP)和一氧化氮(NO)水平。结果治疗后,对照组和治疗组临床有效率分别为80.33%和96.72%,两组比较差异具有统计学意义(P<0.05)。经治疗,两组症状积分均明显降低(P<0.05),且治疗组比对照组降低更明显(P<0.05)。经治疗,两组患者PAC-QOL积分和结肠传输试验积分明显降低(P<0.05),而Bristol和SF-36评分明显升高(P<0.05),且治疗组患者明显好于对照组(P<0.05)。经治疗,两组患者血清SP、5-HT水平均显著升高(P<0.05),而VIP和NO水平均明显降低(P<0.05),且治疗组患者SP、5-HT、VIP和NO水平明显优于对照组(P<0.05)。结论当归龙荟片联合普芦卡必利治疗慢性功能性便秘可有效改善患者临床症状,促进患者生活质量改善,具有一定的临床推广应用价值。     

基于NDR评分评估多发性肝癌根治术后经导管动脉化疗栓塞治疗效果研究

目的 探讨NDR评分与多发性肝癌肝切除术后经导管动脉化疗栓塞术（TACE）疗效的关系。方法 回顾性分析2009年3月至2015年3月在海军军医大学东方肝胆外科医院行肝切除术的505例多发性肝癌病人的临床资料。根据术后是否行辅助性TACE将病人分为TACE组（n=272）和非TACE组（n=233），采用倾向得分匹配（PSM）对病人行1∶1配对。应用Kaplan-Meier法分析术后无复发存活率（RFS）和总体存活率（OS）的差异，并分析NDR评分与TACE疗效的关系。结果 PSM后，TACE组1、3、5年RFS和OS均高于非TACE组（66.8%、41.2%和27.6%；49.6%、37.2%和27.7%，P=0.031；86.1%、63.7%和42.6%；69.1%、49.0%和37.2%，P=0.002）。NDR评分≤2分时，TACE 组1、3、5年RFS和OS与非 TACE 组差异无统计学意义（68.6%、44.1%、29.0% vs. 58.0%、43.3%、35.2%，P=0.445；88.3%、65.0%、44.4% vs. 76.4%、55.0%、45.7%，P=0.109）；NDR评分>2分时，TACE 组1、3、5年RFS和OS均高于非TACE组（60.5%、34.2%、28.5% vs. 20.3%、16.2%、8.1%，P=0.001；78.9%、51.6%、42.8% vs. 43.8%、29.9%、15.9%，P=0.007）。PSM后NDR评分>2分时，多因素分析显示，甲胎蛋白（AFP）和辅助性TACE是无复发生存的独立影响因素（HR=1.90、0.43；P<0.05）；AFP、肿瘤最大最小径比值和辅助性TACE是总体生存的独立影响因素（HR=2.23、2.96、0.53；P<0.05）。结论 NDR评分>2分时，肝癌肝切除术后行辅助性TACE可有效减少术后复发，改善远期生存。对NDR评分>2分的多发性肝癌病人，推荐辅助性TACE作为术后抗复发治疗手段。     

质子泵抑制剂治疗上消化道出血的疗效观察

目的探讨急性非静脉曲张性上消化道出血采用大剂量质子泵抑制剂治疗的疗效。方法将本院2015年6月—2018年6月期间的急性非静脉曲张性上消化道出血患者60例进行分组研究,对照组30例给予常规剂量质子泵抑制剂治疗,观察组30例给予大剂量质子泵抑制剂治疗,对治疗效果等相关指标进行分析。结果观察组治疗效果以及生活质量评分与对照组相比较高,止血时间、输血量、住院时间以及不良反应发生率与对照组想比较低,P<0.05。结论大剂量质子泵抑制剂治疗急性非静脉曲张性上消化道出血效果较好,有助于提高患者生活质量。     

天麻钩藤汤加减治疗肝阳上亢型原发性高血压疗效观察及对神经递质节律的影响

目的:观察天麻钩藤汤加减治疗原发性高血压肝阳上亢型患者的临床治疗效果及对神经递质节律影响。方法:选取2017年1月至2018年1月郑州市第六人民医院收治的原发性高血压肝阳上亢型患者100例作为研究对象,将达到病例选择范围的93例患者按照治疗药物不同分为对照组(n=44)和观察组(n=49)。对照组采取西药基础治疗,观察组采用西药基础治疗+天麻钩藤汤加减治疗。疗程结束后,观察2组血压水平、神经递质节律、中医症状积分。结果:1)观察组晨起平均收缩压、24 h平均收缩压、夜间平均收缩压、晨起平均舒张压、夜间平均舒张压、24 h平均舒张压明显低于对照组(P<0.05);2)观察组神经肽Y、神经元特异性烯醇化酶、血管加压素、强啡肽-A显著低于对照组(P<0.05),P物质、脑源性神经营养因子显著高于对照组(P<0.05);3)观察组甘氨酸、γ-氨基丁酸显著低于对照组(P<0.05),天冬氨酸、谷氨酸显著高于对照组(P<0.05);4)观察组治疗后中医症状总积分显著低于对照组(P<0.05)。结论:针对原发性高血压肝阳上亢型患者,在西药治疗基础上,增加天麻钩藤汤加减治疗,能够有效促进患者神经递质节律的恢复,调节血压,同时对降低中医症状积分,值得临床推广应用。