Parkinson's disease was primarily considered to be a movement disorder affecting only the extrapyramidal system. Although the non-motor symptoms such as neuropsychiatric symptoms, dysautonomia, sleep disturbances and olfactory dysfunction, etc., were also common, they were often misdiagnosed or neglected. This paper would review the manifestation, relevant factors, pathogenesis and treatment of non-motor symptoms of Parkinson's disease.

Objective To investigate the relationship between the infarction area and the changes of serum fibrotic indexes in acute myocardial infarction (AMI) patients.Medthods Serum procollagen type Ⅲ (PCⅢ),collagen IV(IV?C) and laminin (LN) were measured in 42 AMI patients with successful recanalization,22 AMI patients with unsuccessful recanalization and 37 healthy controls.Michelle's method was used to calculate infarction area and correlative analysis was made between indexes and infarction area.Results Serum PCⅢ,IV.C and LN were significantly increased in AMI patients with unsuccessful recanalization as compared with the other two groups,which were positively correlated with the infarction area.However,there was no statistical significance between the indexes in the other two groups and infarction area.Conclusion Serum PCⅢ,IV.C and LN can be serum fibrotic indexes in AMI patients,which can reflect the infarction area indirectly.

[Objective]To investigate the best internal fixation methods of upper segment complicated femoral fractures(USCFF).[Method]Fifty-two cases(54 limbs) with USCFF were treated.In all patients open fracture reduction with use of internal fixation were done.Intramedullary interlocking nails(IIN) were used to treat 32 cases(34 limbs) of adult's USCFF and 130? plate were used to treat 20 cases of children's USCFF.Thirty-six limbs of them were closed fractures,and 18 limbs were opene.Measures of auto-ilium transplant(5 limbs),homolegous allograft bone transplant(10 limbs)were also taken.[Result]Fifty-two patients were followed-up from 9 to 40 months with an average of 16 months.Infection,fracture nonunions,malunion and femoral head necrosis complications were not found.The average period of union of adult and children fractures was respectively 6.8 months and 6.5 months.The long term effect was evaluated according to Ma Yuanzhang's evaluation standard,94.4 percent showed excellent function of joints and limbs.[Conclusion]Appropriate selection of internal fixation according to the age of patients and satisfactory fracture reduction are key points to improve outcome of USCFF.IIN in treating fiacture of adult and 130? plate in treating fracture of children are more ideal selections.

[Objective]To discuss the feasibility and efficacy of the treatment of low subtrochanteric femoral fracture(LSFF) by using general interlocking intramedullary nail(GIIN).[Method]Between March.2000 and January.2006,47 cases(38 males,9 females) of LSFF were treated with limited incision and 6IIN.The mean age of the patients were 41.2 years(range 25 to 78 years).29 of them were injured in a traffic accident,7 in falling,6 in crush by a heavy object and 5 in pedestrain injury.According to Seinsheimer classification,11 cases were type IA,10 cases were type lB,19 cases were type ⅢB,and 7 cases were type Ⅳ(8 combined with other fractures)6 of these were open fractures(4 cases of Gustilo-Anderson type Ⅰ and 2 cases of type Ⅱ).The procedure included following step: all patients were treated with limited open reduction.The pyriform sinus entry point were localized with retrograde reamed;then,intramedullary nail was performed through the anterograde approach after limited reamed.All fractures were fixed statically.The operation time were from 50 minutes to 130 minutes(averaging 90 minutes).[Result]All the cases,were followed up for 11 to 34 months,with an average time of 33 months.The alignment of fracture was good.The bone union time were 2.5～6 months,the average 3.9 months.Fracture union rate was 100%.The functional evaluation was done by Sanders traumatic hip rating scale.of the 47 cases,31 were excellent,14 good and 11 fair.The excellent and good rate was 95.7%.There were no infection,implant breakage,limb shortening and varus deformity.[Conclusion]In treatment of LSFF,the GIIN is worth to recommend because it is simple for use,no need of X-ray monitoring during the operation,reliable,high union rate,rare complications,and good effects.Reasonable application of GIIN,better fracture reduction and early active functional rehabilitation(earlier activities and later weight bearing) are the keys to obtain a good clinical result.

[Objective] To evaluate the feasibilitiy,methods and therapeautical effects of the posterior circumferential fusion (PCF) combined with short -segmental pedicle screw system fixation for the treatment of lumbar spondylolisthesis(LSL). [Method] From October 2002 to March 2006, 44 cases of LSL were treated with decompression for spine canal stenosis, circumferential fusion and short-segmental pedicle screw system fixation. There were 15 male and 29 female, average age was 48. 6 (ranged, 31~68) years. The diagnoses of LSL and stenosis were confirmed by X-ray and CT. According to Newman classification, 15 of them were the degenerative type and 29 were isthmic type. According to Meryerding classification of LSL, 17 patients had degree I, 24 patients had degree Ⅱ and 3 patients had degree Ⅲ spondylolisthesis. The levels of LSL was between L4 and L5,in 18 patients and between L5 and S1 in 26 cases.[Result]The follow-up period was 18~36 months , averaged 26 months.Seventeen patients with degree Ⅰ spondylolisthesis were all reduced anatomically after surgery. Twenty-four patients with degree Ⅱ spondylolisthesis were reduced anatomically except for 6 patients with Ⅰ degree residual spondylolisthesis. 3 patients with degree Ⅲ spoadylolisthesis were reduced anatomically except for 2 spatients with Ⅰ degree residual spondylolishesis. The effect was evaluated according to Hou Shuxun's evaluation standard, the results were excellent in 28 cases, good in 13 cases, and fair in 3 cases. The excellent and good rate was 93.2%. No complication such as interfixation failure and nerve pedicle injury or cauda equine injury were found. All cases got bony union in 3 to 10 months (mean 4.2 months) postoperatively. All patients had normal disc height and no loss of spondylolisthesis reduction. [Conclusion] The PCF combined with short-segmental pedicle screw system fixation is reasonable options in treating the LSL. It can improve the fusion rate of the spine and maintain good intervertebral space and good lordosis of the lumbar spine. The satisfactory clinical result is relied on the completely understanding of the characteristics of PCF and short-segmental pedicle screw fixation.

Objective:To explore the clinical effect of mild hypothermia combined with puncture aspiration operation on the hypertensive intracerebral hemorrhage and its effect on the serum TNF-α,IL-6 and CRP levels.Methods:112 cases of patients with hypertensive intracerebral hemorrhage admitted in our hospital from February 2015 to August 2016 were selected as the research objectives and randomly divides into 2 groups with 56 cases in each group.Both groups were treated with minimally puncture aspiration,and mild hypothermia was performed in the observation group additionally,the clinical effect,complication,short-term prognosis,serum TNF-α,IL-6,CRP levels at different time points before and after operation were compared between two groups.Results:The overall effective rate of observation group was 92.86％,which was significantly higher than of the control group(76.79％.P＜0.05).The incidence of MODS and complications were 0％ and 26.79％ respectively,which were significantly lower than those of the control group(P＜0.05).The serum TNF-α,IL-6,CRP levels of observation group were significantly decreased on the 3rd and 7th day postoperation,which were significantly lower than those before operation (P＜0.01).The serum TNF-α,IL-6,CRP levels of control group on the 3rd day postoperation were similar to those before operation (P＞0.05),but the serum TNF-α,IL-6,CRP levels on the 7th day postoperation were significantly decreased (P＜0.01).The serum TNF-α,IL-6,CRP levels on the 3rd,7th day postoperation were significantly lower than those of the control group at same time points (P＜0.01).The favorable prognosis of observation group was 80.36％,which was significantly higher than that of the control group (62.50％,P＜0.05).Conclusion:Mild hypothermia combined with puncture aspiration operation could effectively reduce the neurological deficits,inhibit the inflammatory response and decrease the mortality.

Objective In this study,we elucidated the role of high mobility group box chromosomal protein 1 (HMGB1) in collagen-induced arthritis (CIA) rat and the antagonist role of ethyl pyruvate by using a rat model of CIA as the research object by comparing the expression of HMGB1 in normal control group,CIA model group and ethyl pyruvate group.Methods Thirty-six rats were randomly divided into 3 groups (n=12):normal control group,CIA group and ethyl pyruvate group.Then the 6 rats were dissected at the 6th,9th week respectively.Thc expression of HMGB1 was analyzed by immunohistochemistry and Pathology-image analysis software in the cytoplasma.The expression of HMGB1 mRNA with real time-polymerse chain reaction (PCR) was evaluate,and the HMGB1 expression of each group were compared with t-test.Results The immunohistochemical results of HMGB1 showed that the expression intensity in the normal control group,CIA model group and ethyl pyruvate group was 2.1±0.6,7.3±1.2,6.0±1.2 respectively at the 6th week; and 2.2±0.7,12.4±4.5,5.5±1.0 at the 9th week respectively.The HMGB1 mRNA real time-PCR results had shown that the relative quantification of the normal control group and CIA model group were 1,2.865,2.602respectively at the 6th week and 1.005,4.694,1.729 at the 9th week.At those two points, the HMGB1 expressions of HMGB1 antagonist group were significantly higher than those of the normal controls (P＜0.05).In addition,there was statistical significant difference(P＜0.05) in the HMGB1 expression when compared with the placebo group.Furthermore, when the degree of HMGB1 expression among the three groups was compared,the HMGB1 antagonist group was decreased significantly (P＜0.05).Conclusion The results has demonstrated that HMGB1 could induce inflammation in the synovial tissue of CIA rats,and has provided the rationale that HMBG 1 could be the target of treating rheumatoid arthritis (RA).The results of this study have shown that ethyl pyruvate could antagonize the effect of HMGB1.This finding may provide a new therapeutic target for the treatment of RA.

Objective To discuss the selection and application of internal fixators in the treatment of aged patients suffering from femoral condyle fracture. Methods 82 aged patients with femoral condyle fracture were treated from February 1995 to June 2002. According to AO/ASIF classifcation,26 cases were classified as type A,17 cases type B, and 39 cases type C. They were treated with internal fixation by 95?angle plate (19 cases), T type plate(5 cases), AO condyle supporting plate (11 cases), dynamic condylar screw (DCS) (23 cases) and Green Seligsen Henry (GSH) (24 cases). Measures of auto ilium transplant or homologous allograft bone transplant (28 cases) were also taken. Results All the cases were followed up for an average of 14.6 months. Merchan grading method was applied to evaluate their knee joint functions. The total excellent and good rate was 90.2%. Conclusions Aged patients with femoral condyle fracture should be treated specially. The fixation should be chosen according to their fracture type so as to ensure fine clinical results. The goal of the operation is to keep the integrity of articular surface of the femoral condyle and to acquire secure internal fixation.

Objective To evaluate the effect of high-frequency chest well oscillation expectoration system on ventilator-associated pneumonia (VAP) and time for withdrawing mechanical ventilation (MV) system in ICU patients with invasive mechanical ventilation (IMV). Methods 100 ICU patients with IMV were divided into observationgroup (n = 50) and control group (n = 50). The high-frequency chest well oscillation expectoration was used in the former group and the mechanical vibration expectoration was used in the latter. The two groups were compared in terms of amount of sputum, vital signs (heart rate, breathing, systolic blood pressure and blood oxygen saturation), time for withdrawing MV system and VAP rate. Results On days 1, 2, 3, 4 and 5, the amount of sputum in the observationgroup was (33.5 ± 4.2)mL/d, (41.1 ± 3.0)mL/d, (38.2± 3 .5) mL/d, (34.8 ± 2.5) mL/d and (31.1 ± 2.1) mL/d, and those of the control group respectively was (27.4 ± 3.1) mL/d, (30.3 ± 3.6) mL/d, (28.1 ± 2.2) mL/d, (25.7±1.8)mL/d and (20.8 ± 1.7)mL/d. The differences between the two groups were statistically significant (P < 0.05). After sputum expectoration, the blood oxygen saturation of the observationgroup was significantly higher than the control group [(97.5 ± 0.9) vs. (95.2 ± 1.0)] (P <0.05), but there were no statistical differences in heart rate, breathing and systolic blood pressure (P > 0.05). The time for withdrawing MV system in the observationgroup and the control group respectively was (5.8 ± 2.2)d and (9.5 ± 1.8)d, (P < 0.05). The rates of VAP in the observationgroup and the control group respectively was 30.0% (15/50) and 52.0% (26/50), with significant difference between them (P < 0.05). Conclusion The high-frequency chest well oscillation expectoration for ICU patients with invasive mechanical ventilation can promote sputum expectoration , improve blood oxygen saturation , shorten the time for withdrawing the ventilator, and prevent the incidence of VAP.

ObjectiveTo investigate the correlation between electro-acupunctured point Houxi(SI3)and activated brain function areas, contrast the images produced with electroacupuncture at left and right points Houxi and make a comparison with electroacupuncture at point Hegu(LI4)in patients with peripheral facial paralysis.MethodPatients with peripheral facial paralysis, six on the left side and six on the right side, were enrolled as subjects. A scan of the whole brain was taken using fMRI during electroacupuncture stimulation. The images were processed using SPM software. An analysis using at-test (P<0.01) showed differences in brain functional images produced with electroacupuncture at different points.ResultElectroacupuncture at left point Houxi increased the signals of brain regions: rightcaudate nucleus, right cingulate gyrus, right parahippocampal gyrus, right superior temporal gyrus, the brainstem and the cerebellar vermis. Electroacupuncture at right point Houxi increased the signals of brain regions: right medial frontal gyrus, left middle frontal gyrus, left anterior cingulate gyrus, rightcingulate gyrus and right superior temporal gyrus.ConclusionThere is a difference in the image between electroacupuncture at point Houxi and at point Hegu or Dicang(ST4). There is also a larger difference in the image between bilateral points Houxi. The brain regions with high-frequency or low-frequency signals are not consistent. The results further prove the scientificalness of “Point Hegu is indicated for diseasesin the face and mouth” and also show that the cognominal acupoints on the two sides ofthe human body may have some differences, e.g. the conduction pathways are not completely the same and the therapeutic effects are not completely consistent.