Parkinson's disease (PD) caused by the deficiency of DA in the substantial nigra-striatum system in the brain is a chronically progressive disease. Early diagnosis and prompt treatment PD can prolong work time and improve life quality of the patient. There are three primary approaches to increase activity of dopaminergic system:vicarious treatment to compensate DA; promote releasing DA in nerve endings of dopamine neurons and to prevent decreasing DA metabolism,as well as application of agonists that stimulate dopamine receptors. Some specialists suggest that application of dopaminergic agonists in the initial stage can not only delay the occurrence of syndrome on side effects with long-term use of levodopa,but also prevent the damage of dopaminergic cell caused by levodopa or its metabolite,and delay the development of PD. There are positive and adverse effects with DA agonists. This paper discussed the usage and side effects of classic and new dopaminergic agonists.

Objective To investigate the differential diagnosis of early-stage Parkinson disease(PD) and vascular Parkinsonism(VP) by 99Tcm-TRODAT-1 single photon emission computed tomography brain imaging.Methods 99Tcm-TRODAT-1 SPECT brain imaging was performed on 47 patients with early-stage PD,26 with early-stage VP and 30 age-matched healthy control subjects.The radioactive ratio of striatum to cerebullum was calculated by region of interest(ROI) technique.The results were analyzed and compared.Results The distribution and quantities of 99Tcm-TRODAT-1 uptake were reduced in contralateral striatum to clinically symptomatic side of the patients with early-stage PD(P0.05).The radioactive ratio of striatum to cerebullum contralateral to the affected limb in the patients with early-stage PD was lower than that in the healthy control subjects while that to patients with early-stage VP were similar to that in the healthy control subjects.Conclusion 99Tcm-TRODAT-1 single photon emission computed tomography brain imaging and semiquantitative analysis are useful to differentiate VP from PD.

Supernumerary tooth is common,but symmetrical supernumerary tooth on both sides is rare.A case of symmetrical supernumer-ary tooth of maxillary posterior teeth area is reported in this paper.

The change of lung lymph after endotoxin-induced lung injury was studied using a sheep model with chronic lung lymph fistula. After endotoxin injection Ppa、PMV、 Q_L、CL_p、L_A/P_A、and Kf all increased markedly. The ratios of effects of pressure and permeability on Q_L were 1:0.53 and 1:2.31 during phase I and phase H respectively. The results indicated that the formation of pulmonary edema after injury related mainly to the increases of PMV and Kf and to the decrease of effective colloid osmotic pressure. The PMV was the main factor of formating edema during phase I and the permeability was that during phase Ⅱ.

A high dose E. Coli endotoxin was infused into unanesthetized sheep withchronic lung lymph fistula. The contents of substance P in plasma, lung lymph, lungparenchyma and also TXB_2 and 6-keto-PGF_1? were measured. The results showed that 120min after infusion substance P increased in plasma and lymph, but its content in paren-chyma decreased at 360 min after infusion. At 30 min after infusion, TXB_2 and 6-keto-PGF_1? levels in plasma showed a marked increase, but their peak values in lung lymphwere shown at 60 min after infusion, and the levels of TXB_2 were much higher than thatof 6--keto--PGF_1?

Sheep with chronic lung lymph fistula were used as model, lung injurywas induced with endotoxin, changes of pulmonary phospholipase A_2(PLA_2) activity wasmeasured and the effect of dexamethasone on PLA_2 activity was also observed. The resultsshowed that after endotoxin infusion PLA_2 activity, thromboxane B_2 (TXB_2) and 6-Keto- prostaglandin F_1? (6-Keto-PGF_1?) increased markedly (P

Objective To explore the prophyl axis and the timing of operation for pancreatic infection in patients with sever e acute pancreatitis(SAP).Methods 2 23 patients with SAP were treated in ICU from 1990 to 1999. The measures adopted against pancreatic infection included fluid resuscitation, nutritional support, antibiotics and prevention of hypoxemia, hypoperfusion and gut barrier dysf unction etc. Indication for operation in SAP was early pancreatic infection from 1990 to 1994. From 1995 to 1999, drainage of pancreatic abscess or localized infection with debridement of necrotic tissues was adopted. Results 23 (10.3%) patients received operation due t o pancreatic infection. The morbidity rate (8.7%) of pancreatic infection betwe en 1995 to 1999 was lower than that (12.4%) between 1990 to 1994. The postoper ative mortality rate (8%) of pancreatic abscess or localized infection was lower than that (50%) of early pancreatic infection. Co nclusion Comprehensive prophylaxis of pancreatic infection a nd delayed operation for pancreatic abscess or localized infection are effective treatment of SAP.

The purpose of applying antibiotics prophylaxis in perioperative orthopedic surgery is to prevent or decrease the risk of infection.The opportune administration is the key point for prevention of infection.The application principle,classification and current situation are reviewed in this paper,its perspective and prospects are also investigated.

Objective To investigate the thyroid structure changes using a high-frequency sonography and thyroid dysfunction in end-stage renal failure(ESRF) patients.Methods From Jan.2012 to Apr.2012,50 ESRF patients and 55 consecutive outpatients(nonthyroid diseases visitors)as normal controls were included in the study.The size of thyroid gland was measured with ultrasonography and the volume was calculated.The internal echo changes and status of nodules were observed.Measurement such as thyroid hormones,parathyroid hormones and renal function were performed all patients.Results The serum level of T3,FT3 in ESRF patients were significantly lower than those of the control patients(1.05 ±0.23 mg/ml vs 1.14 ±0.25 pg/ml,P =0.038;3.1 ± 0.41 pg/ml vs 3.31 ±0.57 pg/ml,P =0.029),while the serum level of TSH was significandy higher in ESRF group than in the control group (3.29 ± 1.77 mIU/L vs 2.37 ± 0.67 mIU/L,P =0.001).Ultrasonography showed that 32％ (16/50) of ESRF patients and 3.6％ (2/55) of the controls had thyroid goiter (P ＜ 0.001).Compared to ESRF patients without nodules,the average age was significantly higher in patients with nodules (52.94 ± 14.21 vs 42.32 ± 11.37,P =0.006).Conclusion ESRF patients tend to have a higher incidence of alteration of thyroid function and nodular goiter which can be effectively assessed by ultrasonography.

Objective To study the diagnosis and treatment of restless legs syndrome(RLS)in the elderly.Methods The diagnosis of RLS was based on criteria proposed by the International Restless Legs Syndrome Study Group.Ten elderly patients with RLS were enrolled in the research. The clinical presentation and treatment results were analyzed retrospectively.Results All 10 patients were complained of compelling urge to move their limbs.The sensory symptoms were involved in the 4 patients' legs,involved both arms and legs in another 5 patients.It occurred unilaterally in the left of I patient.All patients complained of syndromes aggravated in the night, other three patients also had distinct syndromes in the daytime.Three patients had family history of RLS.The unpleasant sensations were partially or totally relieved by movement.Neurophysiological tests in 5 patients were normal.The iron deficiency occurred only in 1 patient with low serum ferritin and iron levels,Rebound and augmentation were observed in 1 patient in the course of three years treatment with Sinemet.All patients administered a dopamine receptor agonist(pergolide)and showed positive results.Oral administration of iron improved RLS symptoms in a patient with iron deficiency. Conclusions The diagnosis of RLS is usually based on the patient's clinical presentation,which has characteristic feature in the elderly.Rebound and augmentation are serious side-effects in the course of long-term treating with L-DOPA.Therapy of RLS with dopamine receptor agonists is firstly chosen.