帕金森病患者非运动症状的临床特征分析

目的通过对帕金森病患者的非运动症状进行分析,探讨非运动症状的临床特征。方法采用＂帕金森病患者非运动症状筛查量表＂对52例帕金森病患者的非运动症状发生数排序,并与病程、年龄、Hoehn-Yahr分期等临床特征进行分析。结果帕金森病患者的非运动症状总发生率为92.3%,其中便秘发生率为76.9%,为最高、最常见,其次为睡眠障碍73.1%,夜尿69.2%,记忆力减退63.5%。非运动症状的发生率随Hoehn-Yahr分期的增高而增加,差异显著（P〈0.01）,与性别、受教育年限无关（P〉0.05）,与发病年龄、病程正相关（P〈0.05）。结论自主神经功能障碍是帕金森病最常见的非运动症状。帕金森病患者非运动症状筛查量表应常规用于帕金森病的非运动症状的筛查。     

86例帕金森病患者非运动症状的临床研究

目的探讨帕金森病(PD)患者非运动症状(NMS)的发生与分布情况及其可能的影响因素。方法对86例PD患者进行NMS问卷(NMS Quest)调查,统计各种NMS的发生率,并对发生率最高的3个症状与性别、病程、H-Y分级及临床分型进行统计学分析。结果全部PD患者中NMS的发生率为96.5%,以便秘、尿频尿急、不宁腿综合征(RLS)最常见。便秘症状男性与女性、病程≤5年与>5年者、临床分型之间相比,差异有显著性意义(P<0.05);尿频尿急症状男性与女性、病程≤5年与>5年者之间相比,差异有显著性意义(P<0.05);而3者的发生均随H-Y分级的增加而增加。结论 PD患者NMS的发生率非常高,以便秘、尿频尿急和RLS最为常见。性别、病程及H-Y分级是影响便秘及尿频尿急的重要因素,随着PD病情进展,3者的发生率也大大提高。     

帕金森病非运动症状的临床分析

目的研究帕金森病(PD)非运动症状的各项发生率及其与临床资料的关系。方法对71例确诊为帕金森病的患者进行非运动症状问卷(non-motor symptom quest,NMSQ)及统一帕金森病评定量表(unified Parkinson's disease rating scale,UPDRS)评估和相关信息登记,研究各项发生率、总发生数特点及其与病程、年龄、H-Y分期、性别、药物剂量等可能因素间的关系。结果 98.59%的PD患者伴有NMS,以记忆力下降(70.4%)、便秘(67.6%)和注意力下降(66.2%)为最常见。PD患者NMS发生数平均为(11.50±4.95)项;轻度患者NMS发生数为(8.14±3.88)项,中度患者NMS发生数为(12.89±4.08)项,二者间差异有统计学意义(t=-4.75,P<0.001)。重度患者NMS发生为(17.85±3.24)项。PD患者非运动症状发生数与患者年龄(r=0.301,P=0.01)、病程(r=0.463,P<0.001)、H-Y分期(r=0.664,P<0.001)、UPDRS总分(r=0.545,P<0.001)呈正相关。结论非运动症状普遍发生在PD患者中,认知障碍及便秘、睡眠障碍发生率较高。非运动症状发生数与PD的严重程度相关。应重视PD患者的非运动症状,给予积极干预和治疗。     

40例帕金森病患者非运动症状的时序性分析

目的通过对帕金森病患者各种非运动症状发生前后的时序进行分析,探讨帕金森病患者非运动症状出现早晚的临床特征。方法对40例帕金森病患者进行"帕金森病常见的非运动症状问卷"结合部分常见的运动症状进行调查,并结合性别、病程等可能的影响因素对非运动症状发生前后时序进行排列评估。结果在40例帕金森病患者中,味觉或嗅觉减退或丧失是最先开始出现的症状,在确诊帕金森病前就开始出现(平均发病前1.2个月出现),且发生率高[57.5%(23/40)];其次出现时间较早的症状依次是皮炎、感到难以入睡或失眠、因为头晕或失去知觉而摔倒,这3个症状平均在确诊后半年内出现,发生率相对较低[分别为12.5%(5/40),27.5%(11/40),5.0%(2/40)];较晚出现的症状有幻觉(看到或听到一些你知道或者被告知并不存在的事情)、发声困难或异常、有不明原因的疼痛(并非已知原因导致如关节炎)、流涎、色觉异常,这5个症状平均在确诊发病6年以后才出现。结论帕金森病患者的非运动症状中,首先出现的是味觉或嗅觉的减退,且早于运动症状;其次是皮炎,睡眠障碍,头晕,较晚出现的是幻觉、发声困难或异常、不明原因的关节疼痛、流涎、色觉异常。     

帕金森病患者非运动症状的临床特征分析

目的:探讨帕金森病非运动症状的临床特征。方法:观察278例原发性帕金森病患者,采用多种量表评估不同临床分期的帕金森病患者的非运动症状的临床表现。结果:帕金森病患者在不同临床阶段均可以伴发多种复杂的非运动症状,其中以自主神经功能障碍的发生率最高达79.1%,在自主神经功能障碍中又以便秘的发生率最高,在晚期帕金森患者中高达91.7%。其他非运动症状如感觉异常、精神症状、睡眠障碍均有不同程度的发生。结论:帕金森病在不同临床阶段常合并有多种复杂的非运动症状,症状的发生随着疾病进展而逐渐增加。     

探讨帕金森病患者非运动症状的临床特征

目的对帕金森病患者非运动症状的临床特征进行研究分析。方法选择帕金森病患者共100例作为研究分析对象,对所有患者临床资料、表现、特征进行分析,将其作为观察组,同期选择100例正常体检人员的资料作为对照组,比较两组人员的各项临床资料。比较两组人员出现非运动症状的情况。结果在所有的帕金森病患者中,出现非运动症状的患者为91例(91.0%),其中出现最为常见为便秘,出现75例(75.0%),其次为睡眠障碍以及夜尿、记忆力减退,分别出现72例(72.0%)、68例(68.0%)、63例(63.0%),还有患者会出现体位性低血压38例(38.0%),少数患者出现精神障碍16例(16.0%)。同时帕金森患者出现非运动症状的几率与患者发病的年龄、病程呈正相关(P0.05),与年龄、性别、文化程度、职业性质等资料无相关性(P0.05),同时随着Hoehn-Yahr分期增高而增加出现率(P0.05)。结论在帕金森病患者中出现最为常见非运动症状为自主神经功能障碍,其次为睡眠障碍,少数会出现精神障碍,与患者的发病年龄以及病程具有相关性,同时随着患者疾病严重程度越高,患者出现非运动症状的情况就越高。     

帕金森病非运动症状52例临床分析

目的 探讨帕金森病非运动症状的疾病表现.方法 选择我院2014年7月—2016年8月收治的帕金森病患者52例作为研究对象,对非运动症状出现的概率进行统计,并且分析与相关因素之间的关系.结果 52例患者中50例(96.15%)表现出非运动症状,非运动症状类型以自主神经功能障碍最为普遍,此外患者表现出睡眠障碍、精神障碍、感觉障碍以及认知障碍等系列症状.对导致患者出现非运动症状的原因进行分析发现,与患者的年龄以及性别无显著相关性,与统一帕金森病评定量表得分以及Hoehn-Yahr分级表现呈正相关.结论 帕金森病患者往往会表现出非运动症状,患者自身及疾病情况均具有一定的关联.     

帕金森病非运动症状的特征研究

目的 探讨帕金森病(PD)非运动症状的发生、不同运动症状分级(H-Y)时的分布及其影响因素.方法 用统一PD评分量表Ⅲ和Ⅴ(UPDRS-Ⅲ、UPDRS-Ⅴ)、PD非运动症状问卷(NMSQuest)、汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、帕金森病睡眠量表(PDSS)及简易智能量表(MMSE)评分对169例PD患者进行评估,并与102名正常组对照.结果 99.41%的PD患者存在非运动症状;76.33%的患者存在抑郁症状,80.47%的患者存在焦虑症状;帕金森病患者的焦虑、抑郁、睡眠及非运动症状明显多于对照组;不同Hoehn和Yahr(H-Y)分级问患者的非运动症状表现及严莺度差异明显;焦虑、H-Y分级、性别、PDSS及MMSE得分进人回归方程.结论 帕金森病患者非运动症状明显,且在不同运动症状分级间表现及严重程度中具有一定特点.     

帕金森病患者非运动症状的临床研究

目的 研究170例帕金森病(PD)患者非运动症状(NMS)的发生率及其与临床特征的相关性,为PD早期诊断、病情进展预测及预后评估提供依据.方法 对170例PD患者进行NMS问卷调查,统计各种NMS的发生率及其在运动症状出现之前的发生率,用Spearman等级相关分析研究NMS发生个数与临床特征的相关性,用χ2检验研究NMS发生率最高的不宁腿综合征(RLS)的影响因素、严重影响患者生活质量的记忆障碍和情绪障碍与病程及病情严重程度的关系.结果 (1)99.41% 的PD患者出现了NMS,发生率最高者为RLS(57.1%),其他依次为身体不适(52.9%)、近记忆障碍(52.4%)、抑郁(51.8%)、疲劳(50.0%);(2)在运动症状出现之前的PD-NMS中,发生率最高者为失眠(55.3%),其他依次为抑郁(48.9%)、无兴趣(48.2%)、嗅觉减退(46.2%)、焦虑(45.9%);(3)PD患者NMS发生数为0～26个,平均为(10±5)个,NMS发生个数与性别、文化程度、年龄、发病年龄、临床分型无相关性(r值分别为0.056、-0.006、0.016、-0.44和0.002,P＞0.05),与病情严重程度、病程明显相关(r值分别为0.170和0.194,P＜0.05);(4)轻、中、重度PD患者RLS、近记忆障碍及情绪障碍的发生率间差异均有统计学意义(χ2值分别为6.288、9.365和29.710,P＜0.05).结论 (1)几乎所有PD患者出现了NMS,发生率最高的NMS为RLS;(2)PD患者在运动症状出现之前可出现多种NMS,失眠发生率最高,对PD的发生及进展具有预警作用;(3)随着病程延长及病情进展,PD患者出现NMS的个数明显增多;(4)随着病情的加重,RLS、近记忆障碍和情绪障碍的发生率明显增加.     

帕金森病运动并发症的临床表现与治疗研究进展

运动并发症是帕金森病(PD)后期最常见的、棘手的临床问题,是晚期PD患者致残的主要原因。运动并发症主要包括症状波动及异动症两种,其发生与年龄、性别、病程及左旋多巴的应用等有关,且常合并存在,临床治疗前首先要识别运动并发症的类型,并进行个体化治疗。本文围绕PD运动并发症的类型、特点及常见运动并发症的治疗等内容进行综述,为临床诊断及针对性治疗提供参考。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.