Search

As of 2022, inactivated SARS-CoV-2 vaccines had been used in more than 91 countries. However, limited real world information was available on the immune responses of the inactivated SARS-CoV-2 vaccine.We used SARS-CoV-2 pseudovirues to determine the neutralizing antibodies (NAbs) to wild type and several global variants and utilized enzyme-linked immunosorbent assay to investigate IFN-γ-secreting T-cell responses to SARS-CoV-2 among 240 vaccinated individuals after two doses of inactivated vaccine in China.A majority of the vaccinated (90%) developed robust NAbs and T-cell responses to SARS-CoV-2 in the first two months after the second dose. After six months, only 37.0% and 44.0% of vaccinees had NAbs and T-cell immunity to SARS-CoV-2, respectively. Immune serum retained most of its neutralizing potency against the Alpha and Iota variants, but lost significant neutralizing potency against the Beta, Kappa, Delta, and Omicron variants. Only 40% of vaccine-sera retained low-level neutralization activities to Omicron, with a 14.7-fold decrease compared to the wild type.The inactivated SARS-CoV-2 vaccine stimulated robust NAbs and T-cell immune responses in the first two months after the second dose but the immune effect dropped rapidly, highlighing that a third dose or additional booster immunizations may be required to boost immunity against SARS-CoV-2.

Introduction Rotigotine was demonstrated to be efficacious and well-tolerated in three placebo-controlled studies (CLEOPATRA-PD/PREFER/SP921) of patients with advanced-stage Parkinson's disease (PD), most of whom were Caucasian. This multicenter phase 3 study (SP1037; NCT01646255 ) was the first to investigate the efficacy and safety of rotigotine in Chinese patients with advanced-stage PD. Methods Chinese patients with PD, inadequately controlled on levodopa (stable dose ≥200 mg/day), with ≥2.5 h/day “off” time, and Hoehn & Yahr stage 2–4, were randomized 1:1 to receive transdermal rotigotine or placebo, titrated over ≤7 weeks, maintained at optimal/maximum dose (4–16 mg/24 h) for 12 weeks. Primary efficacy variable: mean change in absolute “off” time (according to patient diaries) from baseline to end of maintenance. Safety variables included adverse events (AEs) and discontinuations due to AEs. Results 346 patients were randomized and 89.9% completed the study (87.8% placebo; 92.0% rotigotine). All were Chinese (58.7% male; mean ± SD age: 62.2 ± 8.9 years; mean ± SD time since PD diagnosis: 6.62 ± 3.70 years). Rotigotine significantly reduced “off” time vs placebo (LS mean [95% CI] treatment difference: −1.20 h/day [−1.83, −0.57]; p = 0.0002), and resulted in more responders (≥30% decrease in “off” time: 36.9% placebo; 48.8% rotigotine; p = 0.0269). AEs were reported for 86 (50.0%) placebo- and 103 (59.2%) rotigotine-treated patients; 15 discontinued due to AEs (placebo 7; rotigotine 8). The most common AEs (≥5%) were dizziness, nausea, pruritus, and dyskinesia. Conclusions Rotigotine was efficacious in Chinese patients with advanced-stage PD as add-on therapy to levodopa, significantly reducing “off” time vs placebo; the treatment difference was similar to that observed in previous studies of mainly Caucasian patients. Rotigotine was generally well-tolerated and had a similar AE profile to those observed in previous studies.

Summary Aims To compare the once-daily rivastigmine patch 9.5 mg/24 h (10 cm2) versus twice-daily capsule (12 mg/day) in Chinese patients with probable Alzheimer's disease (AD) (mini-mental state examination [MMSE] scores of 10–20). Methods The primary objective was to demonstrate the noninferiority of patch to capsule in Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog) change from baseline to 24 week. Secondary endpoints included cognition (MMSE), overall clinical response (Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change [ADCS-CGIC]), activities of daily living (Alzheimer's Disease Cooperative Study-Activities of Daily Living [ADCS-ADL]), behavior (Neuropsychiatric Inventory [NPI-12]), and safety. Results Similar cognitive improvement was observed in both patch (n = 248) and capsule (n = 253) groups. Statistical noninferiority for ADAS-Cog was not established (least-square means difference, 0.1; 95% confidence interval, −1.2; 1.5). Considering all efficacy parameters into account, both treatments showed similar performance at Week 24. Treatment-related adverse events (AEs) were lower for patch (39.7%) compared with capsule (49.8%). Application site pruritus was reported in 10.9% of patients receiving patch; most cases were mild. Gastrointestinal AEs including nausea, vomiting, and diarrhea occurred less frequently in the patch group (15.8% vs. 28.7%). Conclusion Rivastigmine patch 9.5 mg/24 h is effective and well tolerated in Chinese patients with probable AD.

According to WHO, one of these mass gatherings with critical risk is stampedes. Shanghai "12.31" stampede was a preventable tragedy that the government and event planner hold responsibility for. At the same time, it can be a legacy for improvement in the future. The government should draw experience on the implementation of an emergency preparedness system, in order to improve the rapid emergency response during mass gatherings in the future.

This paper based on the feature of Beijing urban rail transit sectional passenger flow, combined with Elman neural network. After carrying out modeling experiment many times, a reasonable forecast model about the prediction of urban rail transit sectional passenger flow was established. Then the Elman neural network model was used to predict the sectional passenger flow of Beijing Subway Line 1, from Xidan station to Fuxingmen Station. At last the output results was compared with that of BP neural network, the result shows that the Elman neural network is more precise and effective than the BP neural network in the prediction of urban rail transit sectional passenger flow.

At present, there are many problems existing in railway stations, such as excessive numbers and over-crowded layout, which seriously affect the scale benefit generation and rapid expansion of rail freight capacity. Aimed at these problems, a Mixed Integer programming model is proposed. Taking Lanzhou train operation depot for example, applying lingo software, the layout of freight station is obtained.

To meet the requirement of networked urban mass transit, the characteristics of urban mass transit emergency decision-making was analyzed, draw lessons from the thought of case-based reasoning technology, the method which combine CBR technology with expert knowledge was proposed. On the basis of which, the emergency decision-making support system was designed, analyzed the system structure and function module, discussed the key technologies involved in the system, focused on the representation of retrieval technology and case contingency plans and case. Provides support for the modernization of urban mass transit emergency platform.

Objective: This study investigated the association between obstructive sleep apnoea syndrome (OSAS) and flow-mediated dilatation (FMD), Rho-associated protein kinase (ROCK) activity, and C-reactive protein (CRP) concentrations in male patients. Methods: Consecutive patients with symptoms suggestive of OSAS were recruited and divided into non-OSAS (n = 18) and OSAS (n = 32) groups. FMD was measured in the brachial artery; blood samples were taken to measure ROCK activity and CRP concentrations. Results: ROCK activity and CRP concentrations were significantly higher, and FMD was significantly lower, in the OSAS group than in the non-OSAS group. There was a correlation between ROCK activity and FMD. In stepwise multiple regression analyses, the proportion of sleep time spent with an oxygen saturation < 90% was a significant determinant of ROCK activity, while body mass index was the only significant determinant of CRP concentration. The oxygen desaturation index was a significant determinant of FMD. Conclusions: OSAS increased ROCK activity and was a major determinant of endothelial dysfunction.

Objective To explore the clinical features of benign paroxysmal positional vertigo (BPPV) in patients of 40 years old or younger. Methods The clinical features of 40 patients (age ≤40 years) with BPPV admitted from August 2009 to July 2011 were retrospectively analyzed, and compared with that of 286 middle and old-aged patients (age >40 years) with BPPV admitted in the same period. Results The incidence of BPPV in young patients showed a relatively higher incidence (12.3%), with the sex ratio of male to female 1:3 and a mean age of 32.1±6.2 years. The mean latent period of vertigo attack was 1.2±1.3 seconds, and 10 patients (25%) showed no obvious latent period. The median duration of vertigo was 10s. The posterior semicircular canal was involved in 27 patients (67.5%). Cupulolithiasis was found in 6 patients, and all the otolithiasis was found to involve the posterior semicircular canal. The proportion of BPPV with no obvious latency was higher in the young patients than in the middle and old-aged patients (25.0% vs 11.5%, χ2=5.554, P=0.018), but no significant difference in sex ratio, the course of disease, the ratio of involved semicircular canal, the latency and the duration of vertigo attack was found between two groups (P>0.05). Conclusions The incidence of BPPV is relatively higher in youth, more common in females, and the posterior semicircular canal is commonly involved. Compared with the middle and old-aged patients with BPPV, the proportion patients with no obvious latency of vertigo attack in young patients is higher, and the incidence of cupulolithiasis involving posterior semicircular canal is higher in the youth.

Objective To assess the clinical application of Loewenstein Occupational Therapy Cognitive Assessment(LOTCA) in evaluating the impairment of cognition in elderly patients with type 2 diabetes(DM2).Methods Community based 58 elderly patients with DM2 in a community in Shanghai(60 years and older,having received education for 9 years or longer) were enrolled and screened by Mini-Mental State Examination(MMSE).According to the MMSE scores,21 subjects were assigned to case group(MMSE score < 24,implying cognition impairment),and 37 to control group(MMSE score ≥ 24,implying normal cognition).Meanwhile,a group of community-based 40 elderly subjects without DM2(60 years or older,having received education for 9 years or longer,and MMSE score ≥ 24) were enrolled as the blank control.Difference among the baseline data(age,sex ratio and incidence of hypertension) among the 3 groups mentioned above was negligible.The cognition function was assessed with the LOTCA,and the scores acquired were then compared among the 3 groups.Results The total LOTCA scores showed significant difference among the 3 groups.Each LOTCA score,except the score of perception subtest(object identification),was lower in case group than in control and blank group.In control group,the scores were lower than in blank group of the subtest of perception(object constancy),visual-motor organization test and the subtests thereof(reproduction of two-dimensional models,colored and plain block design construction,and reproduction of a puzzle),thinking operation test and the subtests thereof(ROC unstructured,pictorial sequence B,and geometrical sequence),and of concentration test.Conclusions Cognitive impairment may occur in the early stage of elderly patients with DM2.In comparison with MMSE scale,LOTCA is superior in measuring the cognitive impairment during the early stage of elderly DM2 patients and stratifying the severity of the impairment.

This double-blind, placebo-controlled study investigated the efficacy and tolerability of adjunctive topiramate in 86 elderly Chinese patients with refractory partial epilepsy. Patients who had at least four seizures per 4 weeks during an 8-week baseline period, despite medication with up to three standard antiepileptic drugs (AEDs), were randomly assigned to receive topiramate ( n = 46) or placebo ( n = 40). Topiramate dosages were titrated (target dose 200 mg/day orally) for 8 weeks and maintained at stable levels for another 12 weeks; concomitant AEDs continued at original dosages. All patients completed the study: 47.8% in the topiramate group and 7.5% on placebo reached ≥ 50% reduction in complex partial seizures. In the topiramate group, the most common adverse events were dizziness, somnolence, fatigue, headache and difficulty with memory; most events were transient and mild or moderate in severity. It was concluded that 200 mg/day topiramate was effective and well-tolerated in elderly patients with refractory partial epilepsy.

OBJECTIVE: To evaluate the prognostic value of model for end-stage liver disease (MELD) combined with serum prealbumin (PA) in patients with decompensated liver cirrhosis. METHODS: A total of 252 patients were enrolled in the study and followed 1 year. PA was measured and MELD score was calculated on the first day of admission. Analysis of variance (anova) was used to assess correlation between PA level and MELD score. Multivariable Cox proportional hazards model was used to screen the prognosis related factors. Kaplan–Meier survival curves were drawn. RESULTS: Of the 252 patients, 28 died within 3 months, 58 within 6 months and 91 within 1 year. Serum PA level in dead patients was significantly lower than that in survival patients (P 18 (RR = 2.749) and PA

Summary Purpose: To evaluate efficacy and tolerability of levetiracetam (LEV; Keppra®) as add-on therapy in Chinese patients with refractory partial-onset seizures. Methods: In this multicenter, double-blind, randomized, placebo-controlled trial, 206 patients aged 16–70 years with uncontrolled partial-onset seizures were randomized to receive LEV (n =103) or placebo (n =103); 202 patients (LEV, n =102; placebo, n = 100) comprised the intent-to-treat population. An 8-week historical baseline period confirmed eligibility according to seizure count. The 16-week treatment period consisted of a 4-week up-titration period (LEV, 1,000–3,000 mg/day in two equal divided doses) followed by a 12-week maintenance period. Efficacy assessments were based on weekly frequency of partial-onset seizures during the 16-week treatment period. Results: LEV significantly decreased weekly partial-onset seizure frequency over placebo by 26.8% (p < 0.001). Median percentage reductions in weekly partial-onset seizure frequency from historical baseline were 55.9% for LEV and 13.7% for placebo (p < 0.001). The ≥50% responder rates were 55.9% for LEV, compared with 26.0% for placebo (p < 0.001). Freedom from partial-onset seizures during treatment period was achieved by 11 LEV patients (10.8%) and 2 placebo patients (2.0%) (p = 0.012). Adverse events were reported by 65 LEV-treated patients (63.1%) and 62 placebo-treated patients (60.2%); most were of mild-to-moderate intensity. The most common adverse events were somnolence (LEV, 17.5%; placebo, 17.5%), decreased platelet count (LEV, 9.7%; placebo, 9.7%), and dizziness (LEV, 7.8%; placebo, 13.6%). Discussion: Add-on LEV was effective and well-tolerated in Chinese patients with refractory partial-onset seizures.

Subjective and objective measures of sleep structure or quality could help to characterize the chronic sleep disturbances, with relation to patients’ risk factor profiles and co-morbidities. Studies have shown that discrepancies can occur between subjective data regarding sleep disturbances and the impact of insomnia and objective assays, and surrogate markers of sleep and sleep disturbances. Both objective and subjective measures should be incorporated into clinic studies. It seems likely that sleep quality is represented by a combination of more than one subjective sleep parameter. Objective and subjective assessments of sleep quality may relate to different parameters. Future studies incorporated both subjective and objective measures could help to address the sleep disorders.

Hypnic headache is a rare disorder characterized by frequent nocturnal attacks of a generalized headache in the elderly.This is the first report identifying 2 Chinese hypnic headache cases according to its diagnostic criteria. Both of the patients received sodium ferulate (100 or 50 mg, 3 times/d) for 2 or 3 months.The results of polysomnography in our cases indicated the onset of headache attacks in non-rapid eye movement sleep stage 2. Their symptoms were completely relieved for 1 year after the treatment.Our results suggest that sodium ferulate could be a potential treatment for hypnic headache.

Objective To observe and assess the positive rate and accuracy of 'bow and lean test' in the horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV). Methods Ninety-two HSC-BPPV patients who were diagnosed by head roll test (HRT) were enrolled, and then further tested with 'bow and lean test' (BLT) between Oct 1, 2010 and Sep 30, 2011. They were treated by Barbecue maneuver or Brandt-Daroff exercise on the basis of HRT and BLT tests. The positive rate of BLT test was analyzed, and its accuracy for diagnosis and success rate for treatment of HSC-BPPV were compared between HRT and BLT. Results Among the 92 patients, 83(90.2%) of them showed BLT nystagmus. Fifty-seven of 83 (68.7%) patients showed both bowing nystagmus and leaning nystagmus, and 18(21.7%) and 8(9.6%) respectively showed bowing nystagmus alone or leaning nystagmus alone. Among 92 patients, 74(80.4%) of them the affected side could be determined by HRT with 69 BLT positive and 5 BLT negative. Among the 69 BLT-positive patients, 60 patients showed the same result of HRT, and successful result was achieved by manipulation. 9 patients showed different result between BLT and HRT, in whom manipulation failed according to the result of HRT, but succeeded when manipulation was performed according to BLT. In 18 patients(19.6%) it was not able to determine the affected side by HRT, but in 14 patients manipulation was successful when BLT result was applied. In 4 patients BLT failed to evoke nystagmus, but after practicing Brandt-Daroff exercise, vertigo and HRT nystagmus disappeared 3 days later. Among the 92 patients, 65(70.7%) were cured according to HRT, while 83(90.2%) got successful result according to BLT(P < 0.05). Conclusion The positive rate and accuracy for HSC-BPPV by BLT are high. It is a useful method for determining the affected side in HSC-BPPV, and to provide the basis for selecting effective manipulation treatment.

The aim of this study was to investigate the serum concentration of interleukin (IL)-6 in patients with relapsing-remitting MS (RR-MS), compare the difference between males and females, and explore the correlation between the serum concentration of IL-6 and clinical parameters like the current age, the age at onset, disease duration, disability (expanded disability status scale, EDSS), and the number of relapse. We compared the serum concentration of IL-6 in 39 patients with MS and 39 healthy controls matched with sex and age. The serum IL-6 concentration was measured by FlowCytomix. Compared to healthy controls, both the frequency of subjects with detectable level of IL-6 (P=0.005) and the serum concentration of IL-6 (P=0.004) were significantly higher in MS patients. When data were analyzed by gender, statistical significances between MS patients and healthy controls were observed only in females, although the frequency with detectable level and the serum concentration of IL-6 were higher in male MS patients than male controls. The serum level of IL-6 was found to be significantly positively correlated with the number of relapse for female MS patients (r(s)=0.511, P=0.009), with the current age for male MS patients (r(s)=0.700, P=0.005), and with the age at onset for all MS patients (r(s)=0.351, P=0.028). Our results may support that IL-6 is involved in the pathogenesis of MS and indicate that differences exist between male and female patients.

To explore the clinical features of horizontal semicircular canal benign paroxysmal positional vertigo.The clinical manifestations of 239 patients with horizontal semicircular canal benign paroxysmal positional vertigo from August 2003 to December 2010 were retrospectively analyzed.25.7% (239/931) of all the benign paroxysmal positional vertigo patients were the horizontal semicircular canal benign paroxysmal positional vertigo was involved. One hundred and ninety-seven patients showed geotropic nystagmus in head rolling test with a mean latency period of (0.88 ± 0.72) s and a mean duration period of (26.36 ± 19.71) s. Forty-two patients showed apogeotropic nystagmus in head rolling test with a mean latency period of (2.69 ± 1.83) s and a mean duration period of (53.48 ± 43.12) s. Among all the horizontal semicircular canal benign paroxysmal positional vertigo patients, 39 (16.3%) presented horizontal nystagmus with slight upbeating component. The nystagmus latency in apogeotropic nystagmus group was longer than that in geotropic nystagmus group (t = -6.33, P0.001), and nystagmus duration period was also longer (t = -3.99, P0.001). Applied Barbecue maneuver to the patients with geotropic nystagmus, 192 patients were cured after (1.6 ± 0.8) rotations; After applied head shaking maneuver to the patients with apogeotropic nystagmus, 40 patients changed to geotropic nystagmus and cured after (1.9 ± 0.8) rotations.Incidence rate of horizontal semicircular canal benign paroxysmal positional vertigo was higher than expectation. Barbecue maneuver was applied to patients with geotropic nystagmus. While to the patients with apogeotropic nystagmus, head shaking maneuver should be performed firstly and then followed by Barbecue maneuver.

To assess the short-term efficacy of Semont maneuver for unilateral posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV).The short-term efficacy of Semont maneuver was compared with a sham procedure in 128 patients with PC-BPPV by using a double-blinded prospective randomized controlled trial in the setting of a neurologic outpatient clinic in China. Analysis was based on the symptomatic status and the Dix-Hallpike maneuver on the fourth day. At this time, patients in both groups with a still positive Dix-Hallpike test were treated with Semont maneuver, and outcome was again assessed on the seventh day.On the fourth day, 55 (84.62%) of 65 patients in the treatment group showed complete resolution of symptoms compared with 9 (14.29%) of 63 patients in the control group. (p0.001) 59 (90.77%) of 65 and 52 (82.54%) of 63 patients reported resolution of symptoms in the treatment and original sham group, respectively (p = 0.17).Semont maneuver is shown to resolve PC-BPPV effectively, and patients should receive Semont maneuver once the PC-BPPV diagnosis was confirmed.

To analyze the misdiagnosed cases with benign paroxysmal positional vertigo (BPPV).During October 2010 to January 2011, a total of 287 patients with dizziness visited the Dizziness Clinic at Changzheng Hospital, Second Military Medical University. Forty-eight misdiagnosed cases with BPPV were collected and their clinical data were analyzed. All 48 cases were diagnosed by the Dix-Hallpike or Roll test maneuver.(1) CLINICAL FEATURES: there were 38 females and 10 males with an average age of 54 ± 12 years old (range: 31 - 87). Posterior semicircular canal was involved in 75.0% (36/48) whereas the horizontal semicircular and multiple canals in 20.8% (10/48) and 4.2% (2/48) respectively. All patients were treated successfully. And 41 cases (85.4%) were cured on the first visiting day. Recurrences of BPPV occurred in 6 cases during the follow-up. (2) The initial visiting departments consisted of the department of general internal medicine 43.8% (21/48), department of neurology 27.1% (13/48), department of osteology 18.7% (9/48), ear, nosethroat (ENT) department 2.1% (1/48) and other departments 8.3% (4/48). In addition, 68.7% (33/48) of them frequented the general out-patient clinics during their initial visits and the other 31.3% (15/48) used the emergency services. (3) The initial diagnoses included vertebrobasilar insufficiency/cerebral circulation insufficiency 27.1% (13/48), cervical spondylosis 27.1% (13/48), cerebral infarction 4.2% (2/48), Meniere's disease 2.1% (1/48) and others 10.4% (5/48); Besides, 29.1% (14/48) of them had no diagnosis. (4) The average clinic visits per patient were 3.4 times (164 visits/48 cases). (5) The most commonly performed tests included brain computed tomography (CT) (28 person-times), cervical magnetic resonance imaging (MRI) (19 person-times), brain MRI (18 person-times), cervical radiography (18 person-times) and cervical CT (8 person-times).In these misdiagnosed cases of BPPV, most of them were middle-aged women. They were most likely to have their first consultations in the departments of general internal medicine and neurology. Therefore these two departments should pay more attention to applying the maneuver of Dix-Hallpike or Roll test so as to reduce the misdiagnosis of BPPV and the waste of healthcare resources.

It has been reported that cytokines play an important role in the pathogenesis of multiple sclerosis (MS). The aim of this study was to evaluate the serum levels of interleukin (IL)-18, IL-23 and IL-17 in Chinese patients with MS. We compared the serum concentrations of pro-inflammatory cytokines IL-18, IL-23 and IL-17 in 39 patients with MS and 39 healthy controls matched with sex and age. Serum cytokines were measured by FlowCytomix, a kind of cytometric bead-based assay. Correlations between the serum levels of the three cytokines and disability (expanded disability status scale, EDSS), disease duration, current age and age at onset were examined. Serum concentrations of all IL-18, IL-23 and IL-17 were significantly higher in MS patients than healthy controls. There were no significant differences of the three cytokines' levels between female and male healthy controls, while the serum IL-18 level was observed significantly higher (P=0.049) in male MS patients than female MS patients. No significant correlations were observed between any of the three cytokines' levels and EDSS, disease duration and current age. However, IL-23 was found negatively correlated with age at onset in male MS patients (r(s)=-0.775, P=0.041). Our data suggest that all IL-18, IL-23 and IL-17 may be involved in the pathogenesis of MS. However, the relationships of the three cytokines and clinical characteristics of MS need to be further investigated in the future.

Previous work showed that sleep deprivation (SD) impairs hippocampal-dependent cognitive function and synaptic plasticity, and a novel wake-promoting agent modafinil prevents SD-induced memory impairment in rat. However, the mechanisms by which modafinil prevented REM-SD-induced impairment of brain function remain poorly understood. In the present study, rats were sleep-deprived by using the modified multiple platform method and brain function was detected. The results showed that modafinil treatment prevented REM-SD-induced impairment of cognitive function. Modafinil significantly reduced the number of errors compared to placebo and upregulated synapsin I expression in the dorsal hippocampal CA3 region. A synaptic plasticity-related gene, MMP-9 expression was also upregulated in modafinil-treated rats. Importantly, downregulation of MMP-9 expression by special siRNA decreased synapsin I protein levels and synapse numbers. Therefore, we demonstrated that modafinil increased cognition function and synaptic plasticity, at least in part by increasing MMP-9 expression in REM-SD rats.

Background In the last two decades, mild intraoperative hypothermia has become widely accepted as a protective therapy in neurosurgery. However, its effect in intracranial aneurysm surgery remains unclear. Objective The purpose of this study was to assess the perioperative effects and selected adverse events associated with intraoperative mild hypothermia in aneurysm surgery and to compare those with events in normothermic surgery. Methods Three literature databases, namely the Cochrane Library, PubMed and EMBASE, were searched for randomised controlled trials (RCTs) of aneurysm surgery that compared intraoperative mild hypothermia and normothermia from January 1965 to August 2010. Three RCTs were identified. We extracted the following information: author names and publication year; clinical outcome (number of deaths and Glasgow outcome scales); perioperative data (number of moderate or severe intraoperative brain swelling occurrences, hypertensive episodes, ruptured or leaking aneurysms, volume of blood loss during surgery, duration of temporary clipping, and number of patients who received protective drugs, who required rewarming and who were intubated); number of adverse events (cerebral infarctions, brain swelling, myocardial ischaemia or infarction, congestive heart failure, meningitis or ventriculitis and pneumonia). Except for author names and publication year, the data were pooled to perform a mean effect size estimate. The effects of intraoperative mild hypothermia were then analysed. Results The number of patients requiring rewarming in the mild hypothermia group was significantly greater than in the normothermia group (odds ratio, 33.89; 95% confidence intervals, 3.61–318.36). There were no other statistically significant differences. Conclusion Based on available RCTs, especially involving surgery of low-grade aneurysms, intraoperative mild hypothermia showed no advantages compared with normothermia.

Objective: To investigate the clinical value of a minimally-invasive treatment of communicating hydrocephalus using a percutaneous lumboperitoneal (LP) shunt. Method: The clinical and long-term follow-up data of 256 patients suffering from communicating hydrocephalus and undergoing percutaneous LP shunt during 1998 to 2008 were retrospectively analyzed. Results: After the follow-up, which lasted 6 months to 10 years, 219 cases of communicating hydrocephalus recovered well (ventricular size returned to normal and symptoms completely disappeared), 25 cases were brought under control (ventricle size reduced by 50% and symptoms partially abated), and 12 cases showed no obvious changes. Fifteen obese subjects needed modifications of the shunt due to the obstruction of the abdominal end following wrapping, and one subject underwent extubation as the subject was unable to tolerate stimulation of the cauda equina. The effectiveness of shunting was 91.40% and the probability of shunt-tube obstruction, which occurs predominantly in the abdominal end, was only 5.85%, far lower than that of ventriculoperitoneal (VP) shunt. Three subjects had a history of infection following VP shunting. Conclusion: LP shunting is minimally invasive and effective in treating communicating hydrocephalus, with fewer complications.

Background Several classes of medications such as tricyclic antidepressants, anticonvulsants, narcotic analgesics, and α2-δ ligands, such as pregabalin, have been reported to be efficacious in the treatment of painful diabetic peripheral neuropathy (DPN) and postherpetic neuralgia (PHN) in whites. However, no large double-blind, placebo-controlled trials have been reported that evaluated the efficacy of pregabalin for the treatment of neuropathic pain in a Chinese population in China. Objective The aim of this study was to evaluate the efficacy and tolerability of flexible-dose pregabalin in treatment of Chinese patients diagnosed with painful DPN or PHN. Methods This was a double-blind, parallel-group study in which patients were randomized in a 2:1 ratio and treated with either flexible-dose pregabalin, 150 to 600 mg/d, or corresponding flexible-dose placebo for 8 weeks. The primary efficacy end point was change in the mean pain score based on a daily pain rating scale (DPRS; ranging from 0 [no pain] to 10 [worst possible pain]). Secondary end points included Daily Sleep Interference scale, short form-McGill Pain Questionnaire (SF-MPQ) scale, and the Patient Global Impression of Change (PGIC) and Clinician Global Impression of Change (CGIC) scales. Adverse events and physical and laboratory examination results were also collected. Results Pregabalin and placebo treatment groups were well-matched in terms of demographic and patient characteristics. On the primary outcome, end point change in mean DPRS score, treatment with pregabalin (N = 206) resulted in significant improvement compared with results with placebo (N = 102), with a least squares mean difference score of –0.6 ( P = 0.005). With regard to responder rates, 64% and 52% of patients treated with pregabalin and placebo, respectively, reported ≥30% improvement in DPRS scores ( P = 0.04). Treatment with pregabalin also resulted in significant efficacy compared with that of placebo on secondary measures, including SF-MPQ VAS score ( P = 0.012), SF-MPQ present pain intensity index score ( P = 0.003), sleep interference score ( P = 0.023), and PGIC and CGIC scores ( P = 0.004 and P = 0.001, respectively). Adverse events were observed in 50.0% of pregabalin patients and 40.2% of placebo patients ( P = 0.105), with the most common adverse event being dizziness (11.2%). Conclusions Study results suggest that relative to placebo, pregabalin in daily doses of 150 to 600 mg/d was effective and well tolerated in Chinese patients diagnosed with moderate-to-severe DPN or PHN, indicated through improved pain scores and PGIC scores.

We extend the well-known trace formula for Hill’s equation to general one-dimensional Schrödinger operators. The new function ξ \xi , which we introduce, is used to study absolutely continuous spectrum and inverse problems.