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Objective To compare the characteristics of sleep disorder and its effect on health-related quality of life in patients with Parkinson's disease (PD) between early-stage and middleand late-stages.Methods One hundred and fifty-one patients collected in our hospital from September 2014 to May 2016 were divided into PD patients at early stage (grading 1-2,n=82) and PD patients at middle-and late-stages (grading 3-5,n=69) according to Hoehn-Yahr (H-Y) grading.Mini-Mental Status Examination (MMSE),Hamilton Anxiety Rating (HAM-A) scale and Hamilton Depression Rating (HAM-D) scale,Unified Parkinson's Disease Rating Scale Ⅲ (UPDRSⅢ),H-Y grading,Non-motor Symptoms Questionnaire (NMS) and Parkinson's Disease Sleep Scale (PDSS) were used to evaluate cognition states,emotion states,movement functions,disease severity,nonmotor symptoms and sleep disturbances of patients from the two groups.The 39-item Parkinson's Disease Questionnaire (PDQ-39)was used to evaluate the quality of life of PD patients.Results The incidence of sleep disorder in PD patients at middle-and late-stages was significantly higher than that in PD patients at early stage (P＜0.05),and the total scores of PDSS in PD patients at middle-and late-stages were significantly lower than those in PD patients at early stage (P＜0.05).Fragmented sleep (31.7％ and 47.8％) and excessive sleepiness at daytime (38.7％ and 43.5％) were the most common problems in patients from the two groups.Sleep disorder was negatively correlated with duration,and scores of HAM-A,HAM-D,UPDRSⅢ and H-Y grading,while it was positively correlated with MMSE scores in patients from the two groups (P＜0.05).Sleep disorder was negatively correlated with NMS scores and daily levodopa equivalent dose in PD patients at middle-and late-stages (P＜0.05).Multivariate regression analysis indicated that PDSS total scores were negatively correlated with HAMD scores and positively correlated with MMSE scores in all patients (P＜0.05).PDSS total scores were negatively correlated with duration in PD patients at middle-and late-stages (P＜0.05).Sleep disorder was negatively correlated with total scores of PDQ39,mobility,activity of daily living,communication ability and body discomfort in PD patients at middle-and late-stages (P＜0.05).Conclusions The quality of sleep disorder in PD patients at middleand late-stages is worse than that in PD patients at early stage,and the quality of life is further reduced than that in PD patients at early stage.The course of disease has a great influence in sleep disorder of PD patients.
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Objective To explore the application of olfactory assessment and substantia nigra ultrasonography in early diagnosis of Parkinson's disease (PD).Methods Thirty PD patients,admitted to our hospital from March 2015 to March 2017,were served as PD group and 30 healthy subjects were served as control group.Olfactory assessment tool Sniffm Sticks-1 6 and substantia nigra ultrasonography were performed;the sensitivity,specificity and positive predictive value of olfactory assessment,transcranial ultrasonography,and combined measurement for diagnosis of PD were calculated,respectively.Correlations of results of olfactory assessment,transcranial ultrasonography with age,gender,course of disease,and Unified Parkinson's Disease Rating Scale Ⅲ (UPDRS Ⅲ) scores were analyzed.Results There were 25 PD patients with olfactory test (SS-16) scores≤ 10 and 22 control subjects;the olfactory test (SS-16) scores in PD patients were 7.83±2.23,which were significantly lower as compared with those in control subjects (12.03±1.96,P＜0.05);the incidence of olfactory dysfunction in PD group was 83.33％ and that in control group was 26.67％,with statistical significance (P＜0.05).There were 23 PD patients with area of substantia nigra hyperecho≥ 0.20 cm2 and 26 control subjects;area of substantia nigra hyperecho was (0.22±0.06) cm2 in PD group,which was signfciantly increased as compared with control group ([0.11 ±0.07] cm2,P＜0.05);the incidence of pathological substantia nigra hyperecho in PD group was 76.67％ and that in control group was 13.33％,with significant difference (P＜0.05).The sensitivity of olfactory assessment,transcranial ultrasonography,and combined measurement for diagnosis of PD was 83.33％,76.67％,86.67％,indicating that combined measurement had significantly higher sensitivity that the other two method (P＜0.05).SS-16 scores and area of substantia nigra hyperecho were unrelated with gender,age,duration and UPDRS Ⅲ scores (P＞0.05).Conclusion Combination of olfactory test and substantia nigra hyperecho can improve the diagnosis sensitivity of PD.
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Objective To evaluate the effectiveness of MGIT liquid medium fluorescence instrument manual interpretation method for rapid detection of Mycobacterium. Methods Two hundred sputa with newly diagnosed tuberculosis patients were collected from October 2008 to January 2009 in the district hospitals in Shanghai. Of these 200 sputa, 67 sputa were positive AFB, 133 were negative. All the sputa were isolated by L-J, BacT / Alert 3D system and MGIT liquid medium methods. Results Of the 200 sputa specimens,105(52. 5% ) were isolated as Mycobacterium strains. The positive culture rate of the MGIT, BacT/Alert 3D and L-J method was 49. 5% ( 99/200 ), 48. 0% (96/200) and 45.0% ( 90/200), respectively. The MGIT culture positive rate was significantly higher than that of L-J method (x2 = 5.40, P = 0. 020 1 ). Of the 133 sputa with negative AFB, the positive culture rate was 24. 8% ( 33/133 ), 23. 3% ( 31/133 ) and 18. 8% (25/133) with MGIT, BacT/Alert 3D and L-J method, respectively. The MGIT culture positive rate with the AFB negative sputum was significantly higher than that of L-J method (x2 = 5. 33, P = 0. 020 9 ).The median time of detection with MGIT, BacT/Alert 3D system and L-J method was 11 days, 15 days and 22 days, respectively. Comparing the median time of detection of MGIT with BacT/Alert 3D, the difference was statistically significant ( Z = 3.414 ,P ＜ 0. 01 ). Comparing the median time of detection of MGIT with L-J method, the difference was statistically significant (Z =7.083,P＜0. 01).Conclusions MGIT liquid medium manual method is a rapid detection method of Mycobacterium with a high positive detection rate, and do not need expensive equipment This method may suitable to resource limited medical institutions due to its low cost and short round time.
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Objective To investigate the prevalence and risk factor of Ofloxacin resistance among the tuberculosis patients in Shanghai.Methods Totally 447 isolates resistant to anyone of first-line drug (Isoniazid,Rifampicin,Streptomycin and Ethambutol) and 151 randomly selected isolates susceptible to all above drugs were collected from district tuberculosis(TB) hospitals in Shanghai during 2009 to 2010.All 598 isolates were subject to Ofloxacin sensitive test.Logistic regression analysis was conducted to determine risk factors of Ofloxacin resistance.DNA sequencing was applied to study the mutation characteristics in gyrA and gyrB among Ofloxacin resistant isolates.Results Seventy-two(16.1%) of the 447 drug-resistant isolates were found resistant to Ofloxacin,and the Ofloxacin resistant rate among multiple drug-resistant (MDR) isolates was 39.6%(44/111).Ofloxacin resistance was also found in 4(2.6%) of the 151 drug sensitive isolates.Logistic regression analysis showed that first-line drug-resistance MDR(resistant to at least rifampin and isoniazid) and poly-drug resistance(resistance to two or more first-line drugs but not MDR) had significant effect on Ofloxacin resistance(OR = 19.5、5.6,95% CI:6.4 - 59.4、1.7 - 18.1,all P＜ 0.05);re-treatment(OR = 2.3,95 % CI:1.2 -4.0,P＜ 0.05),and a higher age(OR = 1.03,95 % CI:1.0 1 - 1.05,P＜ 0.05)were also significantly associated with Ofloxacin resistance.Resistance mutations in the gyrA and gyrB genes were detected in 62 of 76(81.6%) isolates with phenotypic Ofloxacin-resistance. Conclusions The Ofloxacin resistance rate in Shanghai MDR-TB patients is significantly higher than the pan-susceptible TB patients.Risk factors of ofloxacin resistance are MDR,poly-resistant,retreated patients,age.Among them,MDR has the highest strength of association.