People with Parkinson’s disease (PD) exhibit multi-system damaged. Medication mainly targets impairments related to dopaminergic lesions. Moreover, in later stages of the disease, medication becomes less effective. Rehabilitation therapy is believed that it can improve multiple functional disorders, including myotonia, bradykinesia, and postural gait abnormalities. It not only reduces the severity of non-motor symptoms and improves the quality of life in PD patients, but also delays the development of PD and improves the activity of daily life of patients. This article summarizes the progress of rehabilitation assessment and the therapy of PD.
ObjectiveTo investigate early effectiveness of arthroscopic superior fulcrum reconstruction in the treatment of irreparable massive rotator cuff tear (IMRCT). Methods A retrospective analysis was conducted on the clinical data of 24 patients with IMRCT who met the inclusion criteria between January 2020 and April 2022. Among them, there were 11 males and 13 females with an average age of 56.2 years (range, 42-68 years). There were 12 cases of falling injuries, 3 cases of traction injuries, and the other 9 cases had no obvious causes. The disease duration ranged from 1 to 25 months (median, 6 months). The rotator cuff tears were classified as Hamada grade 2 in 18 cases and grade 3 in 6 cases, and Goutallier grade 1 in 3 cases, grade 2 in 20 cases, and grade 3 in 1 case. All patients were treated with arthroscopic superior fulcrum reconstruction. Visual analogue scale (VAS) score, Constant-Murley score, the University of California at Los Angeles (UCLA) score, and the American Shoulder and Elbow Surgeons (ASES) score were recorded before operation and at 1, 3, 6, and 12 months after operation. Results The operations were all successfully completed. The incisions healed by first intention and no related complications occurred. All patients were followed up 12-33 months (mean, 24.6 months). The VAS, Constant-Murley, UCLA, and ASES scores at different time points after operation were superior to those before operation (P<0.05). All of the above indicators further improved with time. Except for no significant difference in VAS and Constant-Murley scores between 6 and 12 months (P>0.05), the differences between the other time points were significant (P<0.05). At 12 months after operation, according to UCLA scoring standard, shoulder joint function was rated as excellent in 4 cases, good in 19 cases, and poor in 1 case, with an excellent and good rate of 96.0%. MRI showed that there was no graft re-tear and the transplanted tendon and bone tunnel healed. Conclusion The arthroscopic superior fulcrum reconstruction for IMRCT can effectively relieve the pain, improve the shoulder range of motion, and restore good shoulder function.
【摘要】 目的 探讨左氧氟沙星联合阿奇霉素治疗老年难治性呼吸道感染的疗效及安全性。 方法 选择2005年2月-2010年9月收治的高龄难治性呼吸道细菌感染患者68例，随机分为治疗组和对照组。治疗组34例，给予左氧氟沙星联合阿奇霉素；对照组34例，给予左氧氟沙星，两组总疗程皆为15 d。观察两组患者的临床疗效、细菌清除率和不良反应。 结果 治疗组的总有效率为64.71%，对照组总有效率为32.35%，两组差异有统计学意义（Plt;0.05） 。治疗组细菌清除率为76.19%，对照组细菌清除率为36.36%，两组差异有统计学意义（Plt;0.05） 。治疗组和对照组的不良反应发生率分别为5.88%和8.82%，差异无统计学意义（Pgt;0.05）。结论 左氧氟沙星联合阿奇霉素治疗老年难治性呼吸道感染疗效高， 能有效清除细菌， 不良反应较少， 值得临床推广应用。【Abstract】 Objective To evaluate the efficacy and safety of levofloxacin combined with azithromycin on refractory respiratory infections in elder patients. Methods A total of 68 elder patients with refractory respiratory infections in our hospital from February 2005 to September 2010 were randomly divided into two groups: treatment group (n=34) and control group (n=34). The patients in treatment group were treated with levofloxacin combined with azithromycin; while the patients in the control group were treated with levofloxacin alone. The total treatment periods of both groups were 15 days. The therapeutic efficacy, eradication rate of pathogens and the rate of aelverse reactions were observed. Results The therapeutic effect rate was 64.71% in the treatment group and 32.35% in the control group, and the difference between the two groups was statistically significant (Plt;0.05). The eradication rate of pathogens was 76.19% in the treatment group and 36.36% in the control group, and the difference was significant (Plt;0.05). The rate of the adverse reaction was 5.88% in the treatment group and 8.82% in the control group, and there were no significant differences between the two groups (Pgt;0.05). Conclusion Levofloxacin combined with Azithromycin is effective on refractory respiratory tract infection in elder patients, which can effectively remove the bacteria with few adverse reaction.
Objective To evaluate the efficacy of specific immunotherapy in combination with budesonide formoterol dry powder inhaler ( BUD/FM) in the treatment of moderate to severe bronchial asthma. Methods The data of 93 patients with moderate to severe asthma from September 2006 to September 2008 were analyzed. 46 cases who received BUD/FM therapy were recorded as a BUD/FM treatment group, and 47 cases who received BUD/FMand dustmite specific immunotherapy were recorded asa combination treatment group. After 6, 12, 18, and 24 months, asthma symptom scores, pulmonary function,effective rate, and scores of Asthma Quality of Life Questionnaire ( AQLQ) were compared in the two treatment groups. Results Compared with the BUD/FMtreatment group, the effective rate was significantlyhigher ( 83. 0% vs. 65. 2% , P lt;0. 05) , the lung function improvements in FEV1% pred and expiratory peak flow were more significant in the latter period of treatment, and AQLQ scores improved more significantly after 24 months’treatment in the combination treatment group. Conclusion For patients with moderate tosevere asthma, specific immunotherapy in combination with BUD/FMcan improve asthma symptoms and lung function with good compliance and long lasting efficacy.
目的 了解呼吸机相关性肺炎（VAP）患者病原菌情况，探讨其细菌耐药性及治疗策略。 方法 通过查阅2008年1月－2009年12月呼吸与危重症医学科收治的128例VAP患者的病历资料，分析其肺部感染病原菌分布特点及耐药率。 结果 VAP平均发病时间为机械通气后5.8 d，总病死率为35.1%（45/128）。共分离出病原菌262株，其中G?杆菌210株（占80.2%），G+球菌38株（占14.5%），真菌14株（占5.3%）。G?杆菌中占前3位的分别是鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷白杆菌，对青霉素类、头孢菌素类抗菌药物高度耐药，而对亚胺培南等耐药率相对较低；G+球菌主要是金黄色葡萄球菌，其中耐甲氧西林的金黄色葡萄球菌对多种常见抗菌药物高度耐药，而对万古霉素敏感。 结论 VAP的主要病原菌为G?杆菌，常为多重耐药的致病菌，应根据药敏结果选用合理的抗菌药物。
目的 探讨老年社区获得性肺炎的临床特征、病原学特点及抗生素的合理选择。 方法 选择2010年1月1日－12月31日呼吸内科和干部病房住院治疗并确诊为社区获得性肺炎，年龄≥60岁的126例患者，从病原学、临床表现、辅助检查结果及治疗转归方面入手，回顾性分析老年社区获得性肺炎的临床特征。 结果 77.7%（98/126）的老年社区获得性肺炎患者合并有其他基础疾病，其中84.7%（83/98）合并慢性阻塞性肺病，81.6%（80/98）合并高血压，39.2%（40/98）合并冠心病，25.5%（25/98）合并有糖尿病。126例患者中，68.3%（86/126）有气促等呼吸道症状，75.6%（95/126）有食欲减退等消化道症状，61.1%（77/126）有反应迟钝等精神状态的改变；72.2%（91/126）的患者肺部体征明显，而27.8%（35/126）的患者无明显肺部体征；88.9%（112/126）的老年患者胸部CT提示有斑点状、小片状阴影。有89例患者进行了痰培养，其中58例出现阳性结果，46例对头孢菌素敏感、36例对喹诺酮类药物敏感、39例对氨基糖甙类敏感及青霉素敏感。给予抗感染、支持对症治疗后，56.3%（71/126）的患者治愈、33.3%（42/126）的患者病情好转、10.3%（13/126）的患者死亡，死亡原因均为呼吸衰竭。 结论 老年社区获得性肺炎患者临床特征复杂，应重视其社区获得性肺炎的早期诊断，并进行及时有效的治疗。
【摘要】 目的 探讨老老年患者留置尿管内壁细菌生物被膜形成情况及其对导管相关感染(CRI)的影响。〖HTH〗方法〖HTSS〗 分析2007年2月—2009年10月住院的175例留置尿管患者,均为男性,年龄75~96岁,平均86岁。不同留置时间(7~15 d 53例、16~30 d 49例、31~45 d 44例、gt;45 d 29例)的尿管,于拔出尿管后运用超声震荡使尿管内表面生物被膜完全脱落,梯度稀释后进行生物被膜活菌计数,细菌的培养分类及构成比分析；采用扫描电镜观察尿管内壁细菌生物被膜形成的情况；观察尿管留置时间与生物被膜CRI的关系。结果 随着尿管留置时间的延长,尿管内表面生物被膜活菌计数呈指数趋势增长,CRI发生率有升高趋势,各置管时段组间尿管内表面生物被膜活菌计数及CRI发生率比较差异均有统计学意义(Plt;0.05)。扫描电镜见生物被膜的形成随时间的延长而明显增多。结论 细菌生物被膜形成是老老年患者留置尿管相关性尿路感染的重要致病因素,尿管留置时间越长,尿管生物被膜感染的危险性及几率越高。更换尿管或缩短留置时间仍是防止尿管生物被膜感染的主要方法。
ObjectiveTo analyze the status of real world studies (RWS) through registration information of the Chinese Clinical Trials Registry (ChiCTR). MethodsThe website of ChiCTR was searched with the real world as the search term to collect relevant registered items in the real world from inception to May 4, 2022. Descriptive analysis method was used. ResultsA total of 642 registered items were included. The median sample size was 482 cases. RWS were mainly observational studies, and the number of intervention studies was increasing year by year. There were 267 studies (41.59%) at the stage of post-marketing drugs or phase Ⅳ clinical trials. Most of the main measures were endpoints (56.23%), and the most commonly used was overall survival (15.79%). 62.15% of the registered projects met the minimum requirements for registration. ConclusionThe number of RWS registered by ChiCTR shows an increasing trend. At present, the research purpose of RWSs is unclear, and the completeness of registered studies and the overall content compliance of the studies need to be improved.
Objective To explore the role of hydrogen peroxide (H2O2) in inducing chronic oxidative stress in microglia aging. Methods BV2 microglia purchased from ATCC in less than 10 generations were treated with 0, 50, 100, 200 μmol/L H2O2 at different concentrations. According to the concentration of H2O2 used, the BV2 microglia were divided into a control group and H2O2 -50 μmol/L Group, H2O2 -100 μmol/L Group, H2O2 -200 μmol/L Group. Cell proliferation was measured by CCK8 cell proliferation assay. Age-related β-galactosidase (SA-β-gal) staining assay, and expression of age-related cyclin molecules p16, p21, p53 and senescence sssociated secretory phenotype interleukin 1 beta (IL-1β), transforming growth factor-β (TGF-β) and matrix metalloprotein 9 (MMP9) detected by quantitative real-time polymerase chain reaction were used to measure celluar senescence. Results During the induction process, H2O2-200 μmol/L caused significant damage to BV2 microglia, therefore no subsequent testing was conducted. Finally, the control group, H2O2-50 μmol/L group and H2O2-100 μmol/L group cells were collected. The differences in cell survival rate (F=46.176, P<0.001) and positive rate of SA-β-gal staining (F=553.1, P<0.001) among the three groups were statistically significant. The cell survival rate of H2O2-50 μmol/L group had no significant change (P>0.05), while the cell survival rate of H2O2-100 μmol/L group decreased significantly (P<0.001). The positive rate of SA-β-gal staining in H2O2-50 μmol/L group and H2O2-100 μmol/L group was increased (P<0.001), and the positive rate of SA-β-gal staining in H2O2-100 μmol/L group was higher than that in H2O2-50 μmol/L group (P<0.001). The mRNA levels of senescence related cyclin molecules p16, p21 and p53 were up-regulated under the induction of 50, 100 μmol/L H2O2 (P<0.05), and the expressions of IL-1β, TGF-β and MMP9 of senescence associated secretory phenotype were increased (P<0.05). The increase of H2O2-50 μmol/L group was more obvious (P<0.05). Conclusion The aging model of BV2 microglia can be successfully established by inducing 8 d with 100 μmol/L H2O2, and the mechanism may be related to promoting the secretion of p16, p21, p53, IL-1β, TGF-β and MMP9.
Objective To explore the pathological diagnostic value of optical coherence tomography (OCT) in lung cancer. Methods This study selected patients who underwent general anesthesia and electronic bronchoscope biopsy at the Respiratory Endoscopy Center of Sichuan Provincial People’s Hospital from January 1, 2023, to December 1, 2023. White-light bronchoscopy (WLB), auto-fluorescence bronchoscopy (AFB), and OCT examinations were performed in all patients. Lesions were assessed for benign or malignant characteristics based on AFB and OCT before biopsy. The final pathological results were determined according to pathology report. Results A total of 124 patients were included in the study. The accuracy of OCT in differentiating the nature of lesions was 93.55%, significantly higher than AFB (accuracy 83.06%). The accuracy, sensitivity, and specificity of OCT were all higher than AFB. For squamous carcinoma, adenocarcinoma, and small cell lung cancer, the accuracy rates of OCT imaging characteristics were 91.94%, 94.35%, and 94.35%, respectively. Conclusion OCT can improve the accuracy of pre-bronchoscopic tissue pathology biopsy in determining the nature of lesions and provide rapid pathological typing basis, potentially further promoting the development of non-invasive histological biopsy.