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OBJECTIVE To explore the changes of brain white matter of the patients with obstructive sleep apnea-hypopnea syndrome(OSAHS)with magnetic resonance diffusional kurtosis imaing(DKI).METHODS There were 38 patients with OSAHS examined by polysomnogram(PSG)from November 2017 to June 2021,and 32 non-OSAHS controls matched in gender and age who were included in this study.All the subjects were scanned by DKI.The different encephalic regions through comparing kurtosis fractional anisotropy(KFA)values of all encephalic regions between the two groups were found,and the relationship between the KFA values of the different encephalic regions in OSAHS patients and the apnea-hypopnea index(AHI),lowest saturation oxygen(LSaO2)and the percent of the total record time spent below 90%oxygen saturation(TS90%)in PSG were analyzed.RESULTS The KFA values of white matter fiber tracts in corpus callosum,bilateral corona radiata,cingulate gyrus,right superior cerebellar peduncle and inferior cerebellar peduncle of OSAHS group were obviously lower than control group(P<0.05).After controlling for age and body mass index(BMI),the partial correlation between AHI and the KFA values of corpus callosum,left posterior corona radiata,right anterior corona radiata,cingulate gyrus in OSAHS group were also negative(r=-0.344,-0.380,-0.406,-0.53,P<0.05).The partial correlation between LSaO2 and the KFA values of corpus callosum,left posterior corona radiata,right anterior corona radiata,cingulate gyrus,right superior cerebellar peduncle in OSAHS group were also positive(r=0.366,0.406,0.446,0.404,0.342,P<0.05).The partial correlation between TS90%and the KFA values of corpus callosum,left posterior corona radiata,right anterior corona radiata,cingulate gyrus,right superior cerebellar peduncle and inferior cerebellar peduncle in OSAHS group were also negative(r=-0.414,-0.352,-0.355,-0.336,-0.456,-0.360,P<0.05).CONCLUSION Recurrent apnea and hypoxemia at night of OSAHS patients can cause damage to white matter fibers in parts of encephalic regions.
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Objective To analyze the clinical efficacy of functional endoscopic surgery combined with posterior nasal neurotomy in the treatment of recurrent sinusitis with polyps and its impact on important inflammatory indicators,and explore its clinical mechanism of action.Method 54 patients with recurrent sinusitis and polyps who visited our hospital from January to December 2021 were selected and randomly divided into an experimental group(27 cases)and a control group(27 cases).The control group underwent functional endoscopic sinus surgery,while the experimental group underwent functional endoscopic surgery combined with posterior nasal neurotomy.The total effective rate at preoperative,postoperative 6 and 12 months,sino-nasal outcome test-22(SNOT-22)score,Lund-Kennedy score of the nasal endoscopy,and changes in important inflammatory factors[eosinophil(EOS),immunoglobulin E(IgE),interleukin-4(IL-4),interleukin-5(IL-5)]were compared.Results There was no statistically significant difference in the observation indicators between the two groups of patients before surgery.The number of follow-up patients in the experimental group at 6 and 12 months after surgery was 25 and 23,respectively.The number of follow-up patients in the control group at 6 and 12 months after surgery was 26 and 25,respectively.All postoperative observation indicators was significantly improved compared to before surgery;The total effective rate,SNOT-22 score,and Lund-Kennedy score of the nasal endoscopy in the experimental group were better than those in the control group at 6 and 12 months after surgery,and the levels of EOS,IgE,IL-4,and IL-5 in the experimental group were significantly lower than those in the control group at 12 months after surgery,the differences were statistically significant(P<0.05).Conclusion For patients with recurrent sinusitis and polyps,functional endoscopic surgery combined with posterior nasal neurotomy can better inhibit IgE secretion and mucosal inflammatory response,and improve the postoperative treatment effect.
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OBJECTIVE To study the toxicokinetics and tissue distribution characteristics of alpha-amanitin in rats.METHODS The tail venous blood was collected from SD rats before and 5,10,20,30 and 45 min,1,1.5,2.5,4 and 8 h after intraperitoneal injection of alpha-amanitin(1.5 mg·kg-1),and the concentration of alpha-amanitin in blood was determined by liquid chromatography-mass spectrometry(LC-MS/MS).DAS 2.0 software was used to analyze and plot the drug-time curve with toxicokinetic parame-ters.Based on the toxicokinetics results,18 SD rats were randomly divided into three groups.The rats were sacrificed,and left ventricular arterial(LVA)blood and 9 types of tissue samples involving the heart,liver,spleen,lung,kidney,whole brain,small intestine,stomach wall and testis were collected 15 min,40 min and 2.5 h after dosing,and the concentrations of alpha-amanitin were measured by LC-MS/MS to obtain the tissue distribution results of alpha-amanitin in SD rats.RESULTS Toxicokinetics studies revealed that the peak blood concentration(Cmax)was(633±121)μg·L-1,the elimination half-life(T1/2)was(0.72±0.37)h,and the peak time(Tmax)was(0.52±0.16)h.The total clearance rate(CLz)was(1.62±0.26)L·h·kg-1,the area under the curve(AUC0-t)was(946±183)μg·h·L-1,and the mean reten-tion time(MRT0-t)was(1.18±0.17)h.The apparent volume of distribution(Vz)was(1.65±0.86)L·kg-1.The results of tissue distribution study showed that alpha-amanitin was widely distributed in SD rats with the highest concentration in the kidney,followed by the lung,small intestines,stomach wall,LVA blood and liver,but was low in the heart,spleen,testicles and other tissues,and very low in the brain.Alpha-amanitin was absorbed and eliminated quickly,peaked at 40 min in each tissue,and the concen-tration was minimized after 2.5 h.CONCLUSION The absorption and elimination of alpha-amanitin by intraperitoneal injection are rapid in SD rats,and the blood concentration reaches the peak about 31 min after administration,but can not be detected 4 h later.Alpha-amanitin is mainly distributed in the kidney,followed by the tissues and metabolic organs with rich blood flow,such as the lung,small intestines,stomach wall,LVA blood and liver.The content of alpha-amanitin is low in the heart,spleen,testicles and other tissues,and very low in the brain.It is speculated that it may have toxic targeting effect on the kidney and low blood-brain barrier permeability.
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Objective:To investigate the incidence of various non-motor symptoms (NMS) in early stage of Parkinson′s disease (PD) patients and the differences between the body-first and brain-first subtypes.Methods:A total of 121 patients with PD (Hoehn-Yahr stage 1-2) were recruited from PD Clinic, Department of Neurology, Beijing Hospital from January 2012 to January 2015. The general information and clinical features of the patients were collected. The minimal diagnostic criteria of parasomnias described in the International Classification of Sleep Disorders-Revised were used to diagnose rapid eye movement sleep behavior disorder (RBD).According to the sequence of RBD and motor symptoms, the patients were divided into 2 groups: body-first subtype and brain-first subtype. NMS was evaluated by the Non-Motor Symptom Questionnaire (NMSQuest). The clinical features and the incidence of various NMS were compared between the 2 groups. The Unified Parkinson′s Disease Rating Scale (UPDRS) was used to evaluate the severity of the disease, and its third part (UPDRS-Ⅲ) was used to evaluate the motor function of the patients. Hamilton Rating Scale for Depression (HAMD) and Hamilton Rating Scale for Anxiety (HAMA) were used to evaluate the depression and anxiety status of the patients. The sleep status of patients was assessed by Parkinson′s Disease Sleep Scale (PDSS). The quality of life of the patients was assessed by 39-item Parkinson′s Disease Questionnaire (PDQ-39).Results:Of all the patients, 49.59% (60/121) had the body-first subtype and 50.41% (61/121) had the brain-first subtype of PD. There was no significant difference in UPDRS-Ⅲ score between the 2 groups. The average number of NMS in all PD patients was 10.97±4.88. Body-first subtype patients had higher NMS incidence than brain-first subtype in difficulty in swallowing [46.7% (28/60) vs 23.0% (14/61), χ 2=7.507, P=0.006], nausea and vomiting [16.7% (10/60) vs 3.3% (2/61), χ 2=6.069, P=0.014], constipation [85.0% (51/60) vs 55.7% (34/61), χ 2=12.393, P<0.001], fecal incontinence [8.3% (5/60) vs 0 (0/61), χ 2=5.302, P=0.021], difficulty in remembering recent events [58.3% (35/60) vs 32.8% (20/61), χ 2=7.962, P=0.005], loss of interest [43.3% (26/60) vs 24.6% (15/61), χ 2=4.743, P=0.029], inattention [45.0% (27/60) vs 19.7% (12/61), χ 2=8.884, P=0.003], depression [55.0% (33/60) vs 34.4% (21/61), χ 2=5.181, P=0.023], intense vivid dreams [73.3% (44/60) vs 39.3% (24/61), χ 2=14.196, P<0.001] and restless legs [53.3% (32/60) vs 27.9% (17/61), χ 2=8.140, P=0.004]. The differences were significant. Body-first subtype and NMSQuest ( r=-0.489, P<0.001), UPDRS ( r=-0.189, P=0.038), HAMD ( r=-0.231, P=0.011), HAMA ( r=-0.298, P=0.001) and PDQ-39 scores ( r=-0.276, P=0.002) were negatively correlated. Body-first subtype and PDSS score was positively correlated. NMSQuest (Δ R2=0.265, P<0.001) was the main determinant of PDQ-39 score. Conclusions:PD patients are accompanied by various NMS, which is a major factor affecting the quality of life. Compared with brain-first subtype, body-first subtype might have more NMS burden and higher incidence rate in most NMS in early PD patients.
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Objective:To explore the difference of clinical characteristics between senile Parkinson's disease(PD)with depression and unipolar depression.Methods:From March 2019 to March 2020, 53 patients with Parkinson's disease depression and 57 patients with unipolar depression who were admitted to the neurology department of Beijing Hospital were continuously collected.The gender, age and education level of the patients were recorded.The course of disease and other general data of the patients with Parkinson's disease were also recorded.Depression and anxiety of the patients were evaluated by Beck Depression Inventory(BDI)and Generalized Anxiety Disorder Scale(GAD-7). Quality of life of patients with Parkinson's disease was evaluated by 8-item Parkinson's disease questionnaire(PDQ-8). Differences in the assessment results and quality of life scores between the two groups were analyzed.Results:The incidence of depression comorbid with anxiety in elderly PD patients was 52.8%(28/53), lower than that in elderly unipolar depression patients comorbid with anxiety [84.2%(48/57)]( χ2=12.664, P<0.001). The scores of activity inhibition [(1.8±0.8)points]and hyposexuality [(0.4±1.0)points]in elderly PD patients with comorbid depression were higher than that in patients with unipolar depression [(1.1±0.8)points, (0.0±0.0)points]( t=4.399, 2.942, P<0.001, =0.005). Moreover, the incidence of activity inhibition(98.1%)and hyposexuality(15.1%)in PD patients with comorbid depression was higher than that in patients with unipolar depression(78.9%, 0.0%)( χ2=9.680, 9.279, both P=0.002). The scores of self-blame [(1.0±0.8)points]and pain [(1.0±0.8)points]in elderly patients with unipolar depression were higher than those in PD patients with comorbid depression [(0.5±0.7)points, (0.9±0.7)points]( t=-3.902, -2.486, P<0.001, =0.014). Moreover, the incidence of self-blame(66.7%), irritability(78.9%)and image distortion(56.1%)in elderly patients with unipolar depression was higher than that in PD patients(35.8%, 56.6%, 35.8%)( χ2=10.447, 6.320, 4.547, P=0.001, 0.012, 0.033). The scores of PDQ-8 in PD patients with comorbid depression and anxiety [14.8(10.8, 19.0)points]( Z=-3.544, P<0.001)were higher than those in PD patients with depression only [7.0(4.8, 11.0)points]. Conclusions:The focus of depression in elderly PD patients is different from that in elderly unipolar depression patients.Elderly patients with unipolar depression are more likely to be comorbid with anxiety.Depression reduces the quality of life in PD patients, and the comorbidity of anxiety further reduces the overall quality of life in PD patients with depression.
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Objective:To investigate the association between cancer fatalism and optimistic attitudes among colorectal cancer patients, and how the above linkage is moderated by the involvement of patients′ opinions, the family members′ opinions and the physicians′ opinions in treatment decision-making.Methods:A cross-sectional survey was conducted on 64 patients diagnosed with colorectal cancer and awaiting radical colorectal cancer surgery in the Department of General Surgery of Beijing Friendship Hospital Affiliated to Capital Medical University, from January 2021 to December 2021. There were 38 males and 26 females, aged (61.2±13.0) years from 30 to 84 years. Cancer fatalism, optimism attitudes, and the involvement of patients′ opinions, the family members′ opinions and the physicians′ opinions in treatment decision-making were assessed. The patients′ cancer fatalism beliefs were measured by the " Chance" subscale of the Form C of the Multidimensional Health Locus of Control (MHLC-C), optimism attitudes were assessed by the Chinese version of the revised Life Orientation Test (CLOT-R), and the influence of patients′, family members′, and physicians′ opinions in the medical decision-making process was measured by a self-designed single factor scale. Measurement data of normal distribution were expressed as mean±standard deviation ( ± s). Measurement data of skewed distribution were expressed as M( Q1, Q3). Spearman correlation analysis and Chi-square test was used to examine the association between the main outcome variable (patients′ optimistic attitudes) and demographic and clinical characteristics. Interaction was examined by hierarchical linear regression analysis combined with simple slope tests. Results:Cancer fatalism was negatively associated with patients′ optimistic attitudes ( r=-0.35, P<0.01). Optimistic attitude of patients was significantly and negatively correlated with the influence of family members′ opinions on medical decision-making ( r=-0.25, P<0.05). There were significant positive correlations between the influence of patients′ and family members′ opinions ( r=0.50, P<0.01), family members′ and physicians′ opinions ( r=0.67, P<0.01), and physicians′ and patients′ opinions ( r=0.38, P<0.01) in medical decision making. Hierarchical linear regression analysis showed a negative association between cancer fatalism and optimism ( β=-0.32, P=0.01). This association was further moderated by the involvement of family members′ opinions ( β=-0.56, P<0.01) and the involvement of physicians′ opinions ( β=-0.36, P=0.04) in medical decision-making. Simple slope tests revealed that the negative impact of fatalistic attitudes on patients′ optimism attitudes may be potentiated when family members′ opinions have high influence on medical decision-making, while the negative impact may be buffered to some extent when physicians′ opinions have high influence on medical decision-making. Conclusions:Cancer fatalism had a negative effect on patients′ optimism. The high influence of physicians in treatment decision-making buffered the negative effect of cancer fatalism on optimism; the high influence of family members in treatment decision-making potentiated the negative effect of cancer fatalism on optimism. In the process of doctor-patient communication and shared decision-making, for patients with strong fatalistic attitudes, consideration should be given to appropriately increasing direct informational communication between physicians and patients and reducing excessive family intervention in medical decision-making, so as to enhance patients′ autonomy for treatment, promote optimism, and reduce the negative effects of cancer fatalism.
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ObjectiveTo determine the level of anti-measles antibody and its fluctuation trend in children under 8 months old， which may provide evidence for enhancing the measles immunization strategy. MethodsA cross-sectional study was conducted to collect the serum of the children aged 1‒8 months in a children’s medical center in Shanghai. Serum concentration of anti-measles IgG antibody was determined by enzyme-linked immunosorbent assay （ELISA）， and dynamics of IgG antibody level was compared. ResultsA total of 837 children aged 1‒8 months were tested for anti-measles antibody， and there was no statistical difference in the antibody level between boys and girls （P>0.05）. In the age of 1 month children， the average geometric antibody concentration （GMC） was 529.66 IU‧L-1， and the antibody positive rate and protection rate were 86.07% and 29.51% respectively. After the age of 3 months， the antibody level dropped sharply in the age of 8 months children， the GMC decreased to 44.46 IU‧L-1. The positive rate was 12.00%， and the protection rate was 1.00%. The mathematical model of GMC reduction trend in children aged 1‒8 months was Ŷ=-0.144 8X+2.640（R2=0.911 3， P<0.001）. ConclusionThe low level of mother-transmitted protective antibody and its downward trend with age are the important factors leading to the incidence of measles in children aged1‒8 months. It is suggested that intensive immunization should be carried out for women of childbearing age to improve the level of mother-transmitted antibodies in her baby.
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Objective:To evaluate the effects of dexmedetomidine on alveolar epithelial barrier function in rats with ventilator-induced lung injury (VILI), and the role of protein kinase C (PKC).Methods:One hundred clean-grade male Sprague-Dawley rats, weighing 270-320 g, aged 4-5 months, were divided into 5 groups ( n=20 each) using a random number table method: control group (group C), VILI group (group V), PKC inhibitor group (group B), dexmedetomidine group (group D), and dexmedetomidine plus PKC agonist group (DP group). The VILI model was developed by mechanical ventilation with a tidal volume of 40 ml/kg for 4 h in anesthetized animals.Group C breathed air autonomously for 4 h without mechanical ventilation.Group V was mechanically ventilated for 4 h. In group B, bisindolvlmaleimide I 0.12 mg/kg was injected intramuscularly 1 h before mechanical ventilation.In D and DP groups, dxmedetomidine 5.0 μg/kg was injected intravenously at 20 min before mechanical ventilation, and dexmedetomidine was intravenously infused at the rate of 5.0 μg·kg -1·h -1 during mechanical ventilation.In group DP, PKC agonist phorbol-12-myristic acid-13-acetate 15 μg/kg was intraperitoneally injected at 30 min before mechanical ventilation.At 4 h of mechanical ventilation, oxygenation index (OI), lung permeability index (LPI) and wet/dry lung weight (W/D) ratio were measured, the pathological changes of lung tissues were observed, and lung injury was assessed and scored.The expression of PKC, occludin and ZO-1 protein was detected by Western blot, and the expression of PKC mRNA, occludin mRNA and ZO-1 mRNA was determined by real-time polymerase chain reaction. Results:Compared with group C, OI was significantly decreased, LPI, W/D ratio and lung injury score were increased, the expression of PKC protein and mRNA was up-regulated, and the expression of occludin and ZO-1 protein and mRNA was down-regulated in V and DP groups ( P<0.05), and no significant change was found in the parameters mentioned above in B and D groups ( P>0.05). Compared with group V, OI was significantly increased, LPI, W/D ratio and lung injury score were decreased, the expression of PKC protein and mRNA was down-regulated, and the expression of occludin and ZO-1 protein and mRNA was up-regulated in B, D and DP groups ( P<0.05). Compared with group D, OI was significantly decreased, LPI, W/D ratio and lung injury score were increased, the expression of PKC protein and mRNA was up-regulated, and the expression of occludin and ZO-1 protein and mRNA was down-regulated in group DP ( P<0.05). Conclusions:Dexmedetomidine can reduce the damage to alveolar epithelial barrier function in rats with VILI, and the mechanism is related to inhibition of PKC activation and up-regulation of the expression of occludin and ZO-1.
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Objective:To evaluate the role of transient receptor potential vanilloid receptor 1 (TRPV1)/nuclear factor-κB (NF-κB) signaling pathway in dexmedetomidine-induced alleviation of ventilator-induced lung injury (VILI) in rats.Methods:One hundred clean-grade healthy male Sprague-Dawley rats, weighing 270-320 g, aged 4-5 months, were divided into 5 groups ( n=20 each) using a random number table method: control group (group C), VILI group (group V), AMG9810 group (group A), dexmedetomidine group (group D), and dexmedetomidine + RTX group (group DR). VILI model was prepared by mechanical ventilation with a tidal volume of 40 ml/kg for 4 h. In group A, TRPV1 inhibitor AMG9810 30 mg/kg was intraperitoneally injected at 1 h before mechanical ventilation.Dexmedetomidine 5.0 μg/kg was intravenously infused at 20 min before mechanical ventilation, and dexmedetomidine was intravenously infused at the rate of 5.0 μ g·kg -1·h -1 during ventilation in group D and group DR.In group DR, RTX 70 μ g/kg was intraperitoneally injected for 3 consecutive days before mechanical ventilation.At 4 h of mechanical ventilation, the concentrations of interleukin-1beta (IL-1β), tumor necrosis factor-alpha (TNF-α) and IL-6 in bronchoalveolar lavage fluid (BALF) were detected, oxygenation index (OI) and wet/dry lung weight (W/D) ratio were measured, the histopathological changes of lung tissues were observed, and lung injury was assessed and scored.The expression of TRPV1 and NF-κB in lung tissues was detected by Western blot, and real-time polymerase chain reaction was used to detect the expression of TRPV1 and NF-κB mRNA. Results:Compared with group C, the concentrations of IL-1β, TNF-α and IL-6 in BALF were significantly increased, OI was decreased, the W/D ratio and lung injury scores were increased, and the expression of TRPV1 and NF-κB protein and mRNA was up-regulated in group V ( P<0.05). Compared with group V, the concentrations of IL-1β, TNF-α and IL-6 in BALF were significantly decreased, OI was increased, the W/D ratio and lung injury scores were decreased, and the expression of TRPV1 and NF-κB protein and mRNA was down-regulated in A, D and DR groups ( P<0.05). Compared with group D, the concentrations of IL-1β, TNF-α and IL-6 in BALF were significantly increased, OI was decreased, the W/D ratio and lung injury scores were increased, and the expression of TRPV1 and NF-κB protein and mRNA was up-regulated in group DR ( P<0.05). Conclusions:The mechanism by which dexmedetomidine alleviates VILI is partially related to inhibition of the activation of TRPV1/NF-κB signaling pathway and inhibition of the inflammatory responses in lung tissues of rats.
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Objective:To investigate the grey matter alterations of Parkinson′s disease (PD) patients with and without sleep disorders, and to explore the relationship between different sleep-related problems and clinical variables as well as grey matter volume (GMV) in PD.Methods:Forty-six PD patients and 38 healthy controls (HCs) were recruited from January 2018 to December 2021 in the Department of Neurology, Beijing Hospital. PD patients were divided into PD with sleep disorders (PD-S, n=26) and PD without sleep disorders (PD-nS, n=20) subgroups (cutoff points of 82 for Parkinson′s Disease Sleep Scale or less than 5 for each item was considered as an indicator of substantial sleep disorder). The Mini-Mental State Examination (MMSE), the third part of the Unified Parkinson′s Disease Rating Scale (UPDRS-Ⅲ), Hamilton Rating Scale for Anxiety (HAMA), Hamilton Rating Scale for Depression (HAMD), Non-Motor Symptoms Questionnaire (NMSQ), and Parkinson′s Disease Questionnaire-39 (PDQ-39) were used to evaluate cognitive function, motor symptoms, anxious and depressive symptoms, non-motor symptoms, and the quality of life of the patients. Optimized voxel-based morphometry was applied to the magnetic resonance imaging brain images in all participants,and multiple linear regression analysis was used to test the correlation between GMV and sleep quality in patients with PD. Results:Compared with the HCs, PD-nS patients showed decreased GMV in bilateral limbic lobe, parahippocampal gyrus, amygdala, cingulate gyrus, hippocampus, right cerebellum, bilateral frontotemporal lobe, bilateral occipital lobe and the left parietal lobe. PD-S group exhibited reduced GMV in bilateral limbic lobe, parahippocampal gyrus, amygdala, right cerebellum, bilateral frontotemporal lobe and bilateral parietal-occipital lobe, compared to the HCs. Compared with PD-nS, PD-S patients revealed higher depressive (HAMD score: 12.19±5.59 vs 6.95±3.19, t=-4.01, P<0.001), anxious (HAMA score: 12.04±5.32 vs 7.25±4.68, t=-3.18, P=0.003), and non-motor symptoms scores (NMSQ score: 12.92±5.18 vs 9.90±4.10, t=-2.14, P=0.038), poorer quality of life (PDQ-39 score: 35.31±22.01 vs 22.40±9.00, t=-2.71, P=0.010), and reduced GMV in the left insula, frontal, and parietal lobe ( P<0.001, uncorrected, cluster>100). There was a marked relationship between sleep quality and the reduced GMV of the right medial temporal gyrus (β=0.006, 95% CI 0.002-0.010, P=0.003), left middle frontal gyrus (β=0.006, 95% CI 0.002-0.010, P=0.002), the right cerebellum (β=0.014, 95% CI 0.005-0.023, P=0.003), and the right medial occipital gyrus (β=0.017, 95% CI 0.011-0.024, P<0.001). Significant grey matter changes were associated with nocturnal restlessness, mainly within the left limbic lobe, bilateral occipital lobe, the right cerebellum, and parietal lobe (β=0.008, 95% CI 0.006-0.010, P<0.001). Furthermore, nocturia in PD was related to certain grey matter atrophy, including bilateral limbic lobe, the right inferior parietal gyrus, and bilateral frontal lobe (β=0.010, 95% CI 0.008-0.013, P<0.001). The symptom of daytime dozing was correlated with GMV reduction in the right occipital lobe, the left temporal lobe (β=0.014, 95% CI 0.010-0.019, P<0.001). There were also several compensatory brain regions, including bilateral frontal lobe, the left limbic lobe and cingulate ( P<0.001, uncorrected, cluster>60). Conclusions:Sleep disturbance is common in PD, which is related to the anxious and depressive symptoms, non-motor symptoms, and the quality of life. PD patients with different sleep disorders show grey matter alterations in severeal brain regions, which are associated with sleep quality, nocturnal restlessness, psychosis, and daytime dozing.
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Objective To determine the epidemiological characteristics of measles in Jinshan District of Shanghai in 2002‒2019. Methods This study was a secondary data analysis using measles surveillance system and epidemiological case reports in Jinshan District from January 2002 through December 2019. Temporal characteristics of the disease onset was determined by a concentration method. ArcGis 10.4 and SaTScan 9.6 software were used for spatiotemporal clustering scanning analysis. Results From 2002 through 2019， a total of 289 cases of measles were reported in Jinshan District， Shanghai， with an average annual incidence of 2.24 per 105. The annual incidence fluctuated from 0 to 11.27 per 105. The highest incidence was recorded in 2005 （11.27 per 105）， followed by a decline； however， there was a rebound in 2008 （5.26 per 105） and 2015 （3.30 per 105）. The concentration M was determined to be 0.62， showing a clear seasonality concentrated in February to May. The spatiotemporal scan found that spatial and temporal clusters were more likely to occur in the areas with higher population density such as Zhujing Town and Shihua Community and between 2002 and 2009. The majority of measles cases were infants and children under the age of 1 and adults aged 20‒39 years. Approximately 66.78% of measles cases reported unknown vaccination history. In addition， in children aged 8 month to 4 years， the vaccination rate of measles-containing vaccines in the domestic migrants was much lower than the local residents （χ2=4.44， P=0.035）. Conclusion The incidence of measles in Jinshan District presents a downward trend. The population affected has a "two-way displacement"， which is concentrated in the more populated areas. It is necessary to strengthen measles surveillance and implement supplementary immunization programs with measles-containing vaccines for at-risk populations.
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@#Objective To compare the differences in incidence of rapid eye movement sleep behavior disorder（RBD）on Parkinson’s disease（PD） and multiple system atrophy parkinsonism type（MSAP），and to investigate the correlation factors of the RBD screening questionnaire （RBDSQ） scores.Methods Thirty-four PD patients and 30 MSAP patients without dementia within 5 years of onset were included. Baseline data were collected in detail，and UPDRS Ⅲ score，HY staging score and RBDSQ score were performed between the two groups to compare the difference in the incidence of RBD between the two groups，as well as the correlation factors of RBDSQ score.Results The incidence of RBD in prodrome MSA （40.0%） was significantly higher than that in prodrome PD （2.9%，χ2=11.330，P=0.001）.The incidence of RBD in the clinical stage of MSAP（63.3%）was significantly higher than that in the clinical stage of PD（29.4%，χ2=7.401，P=0.007）.The RBDSQ score of MSAP patients was significantly higher than that of PD patients （6.6±3.9 vs.4.7±3.4，Z=-2.084，P=0.037）.There was no clear correlation between RBDSQ scores in PD group or MSAP group and disease course，UPDRS Ⅲ score，MMSE score and disease progression rate. Conclusion Compared with PD group，the incidence of RBD in prodrome and clinical MSAP group was significantly higher than that in PD group. In MSAP patients and PD patients with normal cognitive function，there was no clear correlation between RBDSQ score and UPDRS Ⅲ score and MMSE score.
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Objective To investigate measles antibody levels in healthy people in Jinshan District and their willingness to inoculate measles containing vaccines, and to explore the feasibility of supplementary immunization with adult measles vaccine. Methods People from 4 randomly selected community health service centers were enrolled and divided into groups of 15-19, 20-29, 30-39, and 40 years old and above. Serum was collected for measles antibody level detection and analysis according to the city and foreign household registration. In addition, a questionnaire survey on measles knowledge and vaccination willingness was conducted. Results Of the 234 participants for serum testing, the overall positive rate of measles antibodies (IgG) was 85.47%, and the protection rate was 35.47%. The difference in the positive rate of antibodies in different age groups was statistically significant (χ2=9.78, P=0.02), and the difference in the protection rate was also statistically significant (χ2=14.97, P<0.0012). The positive rate and protection rate were lowest in the group of 20-29 years old, which were 74.19% and 24.19%, respectively. A total of 490 questionnaires were sent out, and 477 questionnaires were effectively returned. Among the 5 questions about measles knowledge, the lowest correct rate was for the transmission route of measles, which was only 48.64%. The willingness to measles vaccination was 85.12%. Multivariate analysis showed that the willingness to vaccination was related to the level of awareness and health education. Conclusion The level of protective antibodies against measles was low in adults in Jinshan District. Health education on measles was insufficient. It is necessary to conduct measles health publicity in institutions with more concentrated personnel. In addition, appropriate measles serological monitoring and supplementary immunization should be carried out for key populations to increase the level of measles antibodies.
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Objective:To investigate the clinical features and associated chronic pain in corticobasal syndrome (CBS).Methods:Clinical data of 8 patients diagnosed as probable CBS or possible CBS admitted to Beijing Hospital during January 2010 to June 2020 were retrospectively analyzed. The clinical information included sex, age, course of disease, chief complaint, neurological examination, blood biochemistry, tumor marker, infection and other laboratory tests; the neuropsychological evaluation included Mini-Mental State Examination (MMSE) scale and Hamilton Depression Scale (HAMD); the imaging studies included cranial magnetic resonance imaging (MRI) and/or 18F-Fluorodeoxyglucose positron emission tomography ( 18F-FDG PET). Results:The main clinical manifestations were asymmetrical movement disorders, including rigidity, tremor, myoclonus and abnormalities in posture and gait. Patients showed poor response to levodopa treatment. Among 8 patients, 7 had apraxia, 5 patients had alien hand, and 5 patients had various degrees of cognitive dysfunction. The cranial MRI demonstrated mild cerebral atrophy which was slightly more severe in the contralateral side of the initially affected limb in 7 of the 8 patients. The 18F-FDG PET scan revealed asymmetric decreased metabolism in the frontal, parietal, temporal, and occipital lobe, as well as in basal ganglia, which was more severe in the contralateral side of the initially affected limb in 5 of the 8 patients. Six of the 8 patients were associated with pain, including dystonic pain in 3 patients, neuropathic pain in 1 patient, musculoskeletal pain in 1 patient, and unexplained pain in 1 patient. Pain was the onset symptom in 1 patient and pain was relieved by taking levodopa in another patient. Conclusions:CBS is characterized by asymmetric dyskinesia and cognitive impairment, and often associated with apraxia, cortical sensory deficits, and alien limb. The MRI and PET are helpful for CBS diagnosis. Pain may be one of the common non-motor symptoms in CBS.
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Objective:To investigate the accurrence and related factors of depression in patients with parkinson's disease (PD).Methods:One hundred PD patients with Parkinson′s disease (PD) were enrolled in Department of Neurology in Beijing Hospital from March to June 2019. The depressive mood, sleep status and health-related quality of life of PD patients were evaluated by Beck Depression Scale (BDI), Parkinson′s Disease Sleep Scale 2 (PDSS-2), and 8 items of Parkinson′s Disease Questionnaire (PDQ-8). Spearman correlation analysis and multivariate regression analysis were used to analyze the related factors of PD depression. Nonparametric test was used to analyze the differences between different sleep disorder domains in PD patients with depression.Results:The total score of BDI in 100 PD patients ranged from 0 to 44, with an average of 9.9±8.6 points; the total score of PDSS-2 ranged from 0 to 43, with an average of 12.0±9.2; the total scores of PDQ-8 ranged from 0 to 24, with an average of 6.4±6.0 points. The detection rate of depression in 100 PD patients was 42.0% (42/100), and the total BDI score of 22 patients with mild depression ranged from 10 to 15 with an average of 13.0±1.9; the total BDI score of 14 patients with moderate depression ranged from 16 to 25, with an average of 19.1±3.0; the total BDI score of 6 patients with major depression ranged from 28 to 44 points, with an average of 33.3±6.4. The depression in PD patients was positively correlated with PDQ-8 score ( t=8.908, P<0.01) and PDSS-2 score ( t=2.286, P=0.02); and 85.7% (36/42) of PD patients with depression had sleep disturbance. The score of sleep disturbance domain of PD patients with depression (9.8±3.9) was higher than that of nocturnal motor symptom domain (4.8±4.5) and nocturnal PD non-motor symptom domain (4.1±3.3) ( P<0.01). The scores of emotional health, relationship with loved ones, attention, communication ability dimensions of PDQ-8 were positively correlated with PD depression ( P<0.05). Conclusion:Depression is a common non-motor symptom of PD patients; and PD patients with depression suffer from reduced quality of life and are more prone to sleep disorders.
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The common clinical manifestations of spinocerebellar ataxia type 2 include ataxia, dysarthria, slower saccades, weakened or disappeared tendon reflexes, etc. It is relatively rare in patients with parkinsonism and cognitive impairment. Parkinsonism is rare in patients with spinocerebellar ataxia type 2, maybe because the degeneration of the substantia nigra striatum system is only manifested in the striatal presynaptic membrane, while the postsynaptic membrane receptors are relatively retained. At the same time, the degeneration of the subthalamic nucleus and the cerebellum prevents parkinsonism.The reason for cognitive decline may be related to the decrease in the network connection between the cerebellum and cerebral cortex in spinocerebellar ataxia type 2 patients.
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BACKGROUND: Polyacrylamide hydrogels have good biocompatibility, but their mechanical properties are poor, which affect their application in the field of biomaterials. OBJECTIVE: To prepare the polyacrylamide-acrylic hydrogels with a particular size by micromolding graphical imprinting. METHODS: Polyacrylamide-acrylic hydrogel was prepared by sequentially mixing different volumes of polyacrylamide solution, acrylic acid and ammonium persulfate solution into an orifice plate containing a micromolded patterned seal. Group A: Polyacrylamide solution 1.4 mL, acrylic acid 0.1 mL; group B: Polyacrylamide solution 1.3 mL, acrylic acid 0.2 mL; group C: Polyacrylamide solution 1.2 mL, acrylic acid 0.3 mL; group D: Polyacrylamide solution 1.1 mL, acrylic acid 0.4 mL; group E: Polyacrylamide solution 1.0 mL, acrylic acid 0.5 mL; group F: Polyacrylamide solution 0.9 mL, acrylic acid 0.6 mL. Six groups of ammonium persulfate solution were all 50 µL. The patterned structure of the hydrogel was observed under a light microscope. The mechanical properties of the hydrogel were examined by an electronic universal testing machine. RESULTS AND CONCLUSION: Light microscope showed that the stripes on the surface of each group of hydrogels were clearly visible. The addition of acrylic acid effectively improved the mechanical properties of hydrogels. As the proportion of acrylic acid increased, the mechanical properties of hydrogels gradually increased. These results suggest that polyacrylic acid/acrylamide hydrogel has good mechanical properties and is expected to have good application prospects in the field of tissue engineering damage repair.
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Objective:To investigate the characteristics of white matter lesions(WML)found by magnetic resonance imaging(MRI)and the relationship with clinical features in patients with Parkinson's disease(PD).Methods:This was a retrospective study by using a method of MRI T2WI-FLAIR.The WML in 87 PD patients were evaluated by using the Fazekas scale and Scheltens scale.Patients were divided into the early PD group[n=47, Hoehn-Yahr(H-Y)stage 1.0-2.0] vs.the middle-advanced PD group(n=40, H-Y stage 2.5-4.0), the non-depressed PD group(n=71) vs. the depressed PD group(n=16), the non-anxions PD group(n=62) vs.the anxions PD group(n=25). An ordinal regression model was used to investigate the correlations of WML with gender, age, Mini-Mental State Examination(MMSE)score, Unified Parkinson's disease Rating Scale-Ⅲ score(UPDRS-Ⅲ), Hamilton Rating Scale for Depression score(HAMD)and Hamilton Rating Scale for Anxiety score(HAMA). Results:Compared with the early PD group, the middle-advanced PD group showed that the WML were increased in lobe of brain(5.30±4.85 vs. 3.43±3.13, P<0.05), especially in the occipital lobe(0.48±0.99 vs. 0.11±0.31, P<0.05). There was no significant difference in the WML between the non-depressed/anxions and the depressed/anxions PD group.After being evaluated by the Scheltens scale, WML in periventricular hyperintensities(PVH)regions( OR=1.13, P<0.01), in brain lobe( OR=1.10, P<0.01)and in basal ganglia regions( OR=1.15, P<0.01)were correlated with age.WML in the brain besides the PV region were correlated with MMSE score( OR=0.68, P<0.01), especially in posterior horns( OR=0.60, P<0.01)and lateral ventricles( OR=0.68, P<0.05). WML in temporal lobe was correlated with MMSE score( OR=0.68, P<0.05). WML in brain lobe was correlated with H-Y stages( OR=2.10, P<0.05), especially in the occipital lobe( OR=3.33, P<0.05). WML in parietal lobe was associated with HAMD score( OR=1.13, P<0.05). WML in basal ganglia regions was related to diabetes( OR=6.34, P<0.05), especially in the putamen( OR=6.86, P<0.01). After being evaluated by the Fazekas scale, WML in PVH region( OR=1.16, P<0.01)and deep white matter hyperintensities( OR=1.13, P<0.01)were correlated with age.WML in PVH region were associated with MMSE score( OR=0.65, P<0.01). WML scores in PD patients had no correlation with gender, hypertension, coronary heart disease, hyperlipemia, UPDRS-Ⅲ score and HAMA score. Conclusions:The WML is present in PD patients, and it is correlated with age, diabetes, severity of disease, depression and cognitive function.
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Objective:To evaluate the effect of dexmedetomidine on the extracellular signal-regulated kinase(ERK)/sodium-potassium ATPase(Na + -K + -ATPase)signaing pathway in lung tissues of rats with mechanical ventilation-induced lung injury (VILI). Methods:Forty-eighty clean-grade male Sprague-Dawley rats, weighing 270-320 g, aged 4-5 months, were divided into 4 groups ( n=12 each) using a random number table method: control group (group C), VILI (alpha2-adrenergic receptor antagonist) group (group V), dexmedetomidine group (group D), and dexmedetomidine plus yohimbine group (group DY). Group C underwent no mechanical ventilation and breathed air spontaneously for 4 h. Mechanical ventilation (respiratory rate 40 breaths/min, tidal volume 40 ml/kg, inspiratory/expiratory ratio 1∶1, PEEP 0, fraction of inspired oxygen 21%) lasted 4 h in group V. Dexmedetomidine was infused intravenously in a dose of 5.0 μg/kg at 20 min before ventilation followed by an infusion of 5.0 μg·kg -1· h -1 throughout ventilation in group D. In group DY, yohimbine 0.1 mg/kg was injected intravenously at 10 min before dexmedetomidine, and the other treatments were similar to these previously described in group D. Blood samples and lung tissues were taken at 4 h of mechanical ventilation to determine the wet/dry weight ratio (W/D ratio), lung permeability index (LPI), alveolar fluid clearance rate (AFC), and expression of extracellular signal-regulated kinase (ERK), phosphorylated extracellular signal-regulated kinase (p-ERK), and Na + -K + -ATPase in lung tissues (by Western blot) and to observe pathological changes of lung tissues. Results:Compared with group C, LPI and W/D ratio were significantly increased, AFC was decreased, p-ERK expression was up-regulated, and Na + -K + -ATPase expression was down-regulated in group V and group DY ( P<0.05), and no significant change was found in the incidence of the parameters mentioned above in group D ( P>0.05). Compared with group V, LPI and W/D ratio were significantly decreased, AFC was increased, p-ERK expression was down-regulated, Na + -K + -ATPase expression was up-regulated ( P<0.05), and the pathological changes of lung tissues were significantly attenuated in group D, and no significant change was found in the incidence of the parameters mentioned above in group DY ( P>0.05). Compared with group D, LPI and W/D ratio were significantly increased, AFC was decreased, p-ERK expression was up-regulated, Na + -K + -ATPase expression was down-regulated ( P<0.05), and the pathological changes of lung tissues were accentuated in group DY. Conclusion:The mechanism by which dexmedetomidine alleviates VILI may be related to activating alpha2-adrenergic receptors and inhibiting ERK/Na + -K + -ATPase signaling pathway in rats.
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Objective To analyze the impact of depressive symptoms on quality of life in patients with Parkinson's disease(PD)based on middle-and long-term follow-up study,and to explore predictors for the reduced quality of life in PD patients.Methods Clinical data of 80 PD patients were searched from the electronic database in our research center.Patients who had complete general information and the following data of unified Parkinson's disease rating scale(UPDRS),Hoehn and Yahr scale(HY),mini-mental state examination(MMSE),Hamilton depression rating scale(HAMD),Hamilton rating scale for anxiety(HAMA),the 39-item Parkinson's disease questionnaire(PDQ-39),etc.after one-year follow-up were included in this study.The differences in quality of life were analyzed and compared among the non-depression group (n =38),depression remission group (n =22) and depression group(n=20).A follow-up visit was conducted after four years.The disease progression and decline in quality of life were compared between the depression and non-depression groups according to the baseline value of the Hamilton Depression Rating Scale.According to the change in PDQ-39 value,cluster analysis was used to reclassify patients into fast-decline group and slow-decline group.Logistic regression analysis was used to determine independent risk factors for the decline of quality of life.Results At the end of 1 year follow-up,the quality of life was decreased in the depression group as compared with the baseline(P =0.017),and the score of PDQ-39 was higher in the depression group than in the non-depression group and depression remission group.At the end of 4-year follow-up,UPDRS total score,UPDRSⅢ score,HY stage and PDQ-39 score were increased as compared with the baseline,the quality of life decreased more significantly,and the disease progressed faster in the depression group than the other two groups(P ＜0.05).The differences in the disease course,total score of UPDRS,HY stage and HAMD score were statistically significant between the fast-decline group and slow-decline group(P =0.001,0.039,0.003 and ＜0.001,respectively).Logistic regression analysis showed that disease course (OR =1.254,P =0.020),and baseline HAMD score (OR =1.450,P =0.003) were the independent risk factors for the decline of quality of life.Conclusions The quality of life of PD patients is worse in the depression group than in the depression remission group and non-depression group.In PD patients with depressive symptoms,the illness progression is faster,and the quality of life is decreased more significantly.The disease course and depression can predict the decline of quality of life in PD patients.