Therapeutic hypothermia used for clinical purposes has had a long history. With the continuous development in the intensive care and surface cooling techniques, it has made various large hypothermia clinical trials possible. Studies have found that moderate hypothermia (28～35℃) has significant protective effects on important organs such as heart and brain, and it does not have obvious side effects. Recently, mild hypothermia (32～35℃) has been widely used for cardio-pulmonary-cerebral resuscitation, and its effect is satisfactory.

Objective To explore the nursing care for the stiff-man syndrome patient.Methods Retrospective analysis had been performed for the nursing care of a patient with stiff-man syndrome.Results After 4 weeks of careful treatment and nursing care,the patient was discharged from the hospital.Conclusions Suitable nursing according to patients' condition,medication monitoring,psychological care,safety nursing and health guidance can prevent or delay the development of the disease and promote comprehensive rehabilitation for patients.

Substantia nigra is the largest nuclei in midbrain, which is divided into a compact part and a reticular part. Recent studies have shown that the changes of iron content in reticular part of substantia nigra results in the changes of substantia nigra echogenicity. The substantia nigra detected by transcranial Doppler, according to its echo changes, may provide help for the susceptibility of Parkinson's disease, latency and early diagnosis, as well as for the differential diagnosis of multiple system atrophy and vascular parkinsonism.

Objective To explore the factors affecting the quality of life in patients with Parkinson's disease(PD).Methods The quality of life,severity of disease,activities of daily living,motor responses,mental state and the complications of treatment in 71 patients with PD were evaluated by the PD Quality of Life Questionnaire(PDQL),Unified PD Rating Scale(UPDRS),the Hoehn-Yahr scale,the Schwab and England disability scale,the Hamilton Depression Rating Scale for Depression(HRSD),and meanwhile factors such as age,gender,age of onset,the beginning symptom,the location of onset,smoking,doses of L-dopa and fluctuations etc were evaluated by some methods.Results Bivariate analysis showed that the longer course of disease and treatment,the more doses of L-dopa,the higher scores of UPDRS and the Hoehn-Yahr scale,and depression fluctuations with patients,the worse quality of life they had(P

Objective To identify the association between fatigue and depression in Parkinson's disease(PD).Methods 56 PD patients were enrolled in this study.The degree of fatigue was measured by Fatigue Severity Scale (FSS).Hamilton Depression Scale (24 items) was used to evaluate the degree of depression.PD Quality of Life Questionnaire (PDQL) were tested to evaluate the quality of life in PD patients.While other clinical information such as Unified Parkinson's Disease Rating Scale (UPDRS) Ⅲ,Hoehn-Yahr Scale and modified Webster Scale were investigated.Results The incidence of fatigue in this group is 71.4％ (40/56).Score of HAMD and PDQL exhibited a significant correlation to patients' fatigue,coefficient of partial correlation was 0.451 (P ＜ 0.01),-0.346 (P ＜ 0.05).The incidence of fatigue in non-depressive patients was low,27.3 ％.While in depressive patients,the incidence of fatigue is relatively high,for mild depression 75％,moderate depression 100％,severe depression 100％ respectively.Conclusions Fatigue is a prominent symptom of depression in PD patients,sometimes independent of depression also influencing the patients' quality of life.

Objective To detect the change of serum cystatine C ( cys C ) level in Parkinson ’ s disease ( PD ) patients with obstructive sleep apnea-hypopnea syndrome ( OSAHS ) and explore its influencing factors .Methods Fifty-six PD patients with polysomnography examination from July 2011 to December 2013 in the Department of Neurology , the Second Affiliated Hospital of Soochow University were collected.Eighteen healthy controls who took the polysomnography examination during the same period were included.According to the apnea-hypopnea index ( AHI) , PD patients were further divided into two groups:PD with OSAHS group ( n=26 ) , and PD group ( n=30 ).The general conditions , movement function , biochemistry parameters , and sleep parameters were assessed.Statistical analysis was performed using SPSS ver 17.0 software.Results The mean serum levels of cys C in PD with OSAHS group , PD group and control group were (1.05 ±0.17) mg/L, (0.96 ±0.12) mg/L and (0.84 ±0.20) mg/L, respectively.Statistical analysis showed that there was significant difference in the three groups (F=9.184,P<0.05), and the mean serum level of cys C in PD with OSAHS group was the highest.In PD with OSAHS group , Spearman correlation analysis showed a positive and significant correlation between cys C levels and creatinine levels (r=0.459,P =0.018), urea levels (r =0.405,P =0.040), AHI (r =0.482,P =0.013), the oxygen desaturation index (r=0.408,P=0.038), the arousal index (r=0.392,P=0.047) as well as Hoehn and Yahr (H-Y) stage (r=0.467,P=0.016).Correlation was not observed between cys C levels and other clinical parameters (P>0.05).Multivariate analysis showed that creatinine levels (B=0.007,P=0.005), AHI (B=0.004,P=0.013) , H-Y stage (B=0.102,P=0.026) may be influencing factors of cys C levels in PD patients (P<0.05).Conclusions Cys C level is elevated in PD patients, especially in PD patients with OSAHS.The degree of hypoxia and severity of PD is related to the level of cys C in PD patients with OSAHS .

Objective To explore the type and etiology of chronic pain in patients with Parkinson's disease (PD),and to assess the association between pain and cognitive function.Methods A total of 116 PD patients were enrolled in the study and assessed with the following rating scales:Unified Parkinson's Disease Rating Scale (UPDRS),Hoehn-Yahr Scale (H-Y),Hamilton Depression Rating Scale for Depression(HRSD),Visual Analogue Scale (VAS) and Montreal Cognitive Assessment (MoCA).Results Compared with PD patients without pain,PD patients with pain had higher scores of UPDRS,H-Y and HRSD rating scales.Depression(scores of HRSD) was the only factor associated with pain showed by the Logistic regression model (P =0.007).PD patients with pain had lower scores of delayed recall (P =0.020).PD patients with pain happened before their motor symptoms had a lower score of delayed recall (P =0.015).Conclusions Musculoskeletal pain is the most common type in PD patients with pain.Depression is probably an independent risk factor for pain in PD patients.Delayed recall is the dominant impaired cognitive function.

Objective To explore the specific role of autophagy and ubiquitin-proteasome pathway in apoptosis, specific protease inhibitor and (or) macroautophagy inhibitors.Methods The stimulators were selected to work on the pheochromocytoma (PC12) cell lines transfected with human mutant α-synuclein (A53T).Cell activity and apeptosis rate were detected by MTT law and flow cytometry.NO energy, heat shock protein 70 (Hsp70) and Caspase-3 expression were determined in cell culture.Results A53T cell survival rate significantly decreased 24 hours after handling with the protease inhibitor (100 nmol/L) and (or) autophagy inhibitors 3-MA (10 mmol/L, A =0.23±0.01,0.19±0.01 and 0.17±0.01 respectively; P <0.05) compared with the control group (A =0.32±0.06).Cell survival rate was significantly higher than the other drug group after 24 hours handling with autophagy stimulators (A =0.44±0.08).Compared with the control group or autophagy stimulator of rapamycin (0.2 μg/ml) group (1.55%±1.15%), A53T cells apeptosis percentage rate was significantly higher after treated with proteasome inhibitor and macroautophagy inhibitors 24 hours (4.74%±0.91%, 4.59%±1.18% and 5.40%±1.75%respectively, P <0.05); and a slight decrease with stimulators.Protein Hsp70 and NO were significantly higher in proteasome inhibitor groups than the control group.But in antophagy inhibitor and stimulator group, NO and Hsp70 protein was similar to the control group.Conclusion The inhibition of macroautophagy and proteasome can promote apoptosis.Inhibiting or stimulating autophagy has less impact on Hsp70 and NO than proteasome pathway.

Objective To study the incidence of depression in essential tremor (ET) and associated factors. Methods Depression in 62 ET patients and 60 healthy subjects as control was evaluated by means of Hamilton Depression Scale ( HAMD ) , as well as Fahn-Tolosa-Marin Tremor Rating Scale (TRS) and Pittsburgh Sleep Quality Index (PSQI). Results Fifty-three point two percent(33/62) of ET patients and 11.7% (7/60) of healthy subjects were found to have at least mildly depression (HAMD score of 8 or higher), 35. 5% (22/62) of ET patients and 8. 3% (5/60) of healthy subjects fell into the mildly-to-mederately depression (HAMD score between 8 and 20 ), 17.7% (11/62) of ET patients and 3.3% (2/60) of healthy subjects were classified into moderately-to-severely depressed range (HAMD score between 21 and 35). There were statistical differences in ET group and healthy subjects group (X2= 23.898, 13.043, 6.649, all P <0.01). Additionally, there were statistical differences in anxiety/ somatization (t=-6.747, P<0.01), cognitive impairment (t=-2.017, P=0.05), block(t= -4.145, P<0.01), sleep disorders (t=-4.500, P<0.01) and despair (t=-3.591, P<0.01) between depression group and non-depression group. There were marked differences in PSQI total score ( t =-3.196, P=0.003 ), subjective sleep ( F1, t=-3.037, P=0.004), quality sleep latency (F2, t= -4.674, P<0.01) and sleep disturbances (F5, t=-2.594, P=0.013 ) between depression disorder group and non-depression disorder group. Meanwhile, the score of TRS, PSQI and sex were closely correlated with HAMD (β=0.589, P=0.000 ;β=0.469,P=0.000 ;β=0.256, P=0.027 ). Conclusions The incidence of depression is high in ET. Manifestation of depression are anxiety, reduced interest in work, sleep disorders, retardneas, inferiority complex, etc. The degree of symptoms relates to the severity of ET, sleep quality and gender.

Objective To survey the prevalence, distribution of non-motor symptoms (NMS) in essential tremor (ET) and the relationship with disease severity and duration.Methods Fahn-Tolosa-Matin Tremor Rating Scale (TRS) was used to assess motor symptoms in 62 patients with ET.The Parkinson's disease (PD) NMS Questionnaire and T&T olfacmeter and Mini-mental State Examination (MMSE) were used to explore non-motor symptoms in ET patients.Results In ET, a range of NMS occurred across all disease stages.More than half patients (51.6%, 32/62) had olfactory dysfunction,significantly higher than the healthy control group (30.0%, 18/60, x~2=12.371, P<0.05).A third had hyposmia.16.1% had partial olfactory loss.Each ET patient had 5 different NMS on average.Seven NMS were more common in ET patients than in control, including remembering, olfactory dysfunction, intense vivid dreams, anhedonia, depression, anxiety, sleep disorders.The incidences of remembering, olfactory dysfunction,intense vivid dreams were 58.1% (36/62),51.6% (32/62),48.4% (30/62), ranked top 3 in ET patients.Olfaction had inverse correlation with age, while there was a negative correlation between NMS score and TRS score, gender, disease duration and weather to be treated.Conclusion Besides posture tremor and kinetic tremor,NMS occur in ET,and should be well recognized and treated.