Objective The clinical efficacy and safety of L dopa monotherapy and concomitant L dopa therapy with dopamine agonists (bromocriptine or pergolide) of the treatment of Parkinson's disease Methods The clinical trial was performed in the multicentre,open label study L dopa group: 47 cases,L dopa plus bromocriptine group: 43 cases and L dopa plus pergolide group: 48 cases The clinical efficacy was assessed with modified Webster's scale and motor dysfunction rating scale for Parkinson's disease ( MDRSPD ),and safety data included blood hepatic and renal function tests,blood and urine routine tests,arterial blood pressure,heart rate measurements and electrocardiogram were also analyzed at the beginning and end of study The average daily dose of L dopa in levedopa group was (523 3?235 9) mg,The average daily dose of L dopa and bromocriptine were (526 7?241 3) mg and (7 3?1 5) mg in L dopa plus bromocriptine group,respectively The average daily dose of L dopa and pergolide were (558 3?192 9)mg and (0 235?0 045) mg in L dopa plus pergolide group separately Result The clinical improvement was about 74 5%both in assessment of modified Webster's scale and MDRSPD in L dopa group The clinical score was improved in 69 8% (Webster's scale) and 79 1% (MDRSPD) in L dopa plus bromocriptine group,respectively The clinical improved rates were 77 9%( Webster's scale ) and 81 3%( MDRSPD ) in L dopa plus bergolide group The incidence rates of side effects were 27 7%in L dopa group,39 5%in L dopa plus bromocriptine and 18 8%in L dopa plus pergolide groups Conclusion There was an efficacy in treatment of Parkinson's disease in either L dopa monotherapy or combination with bromocriptine or pergolide The treatment of L dopa alone was more effective in the early stage of Parkinson's disease and concomitant L dopa therapy with dopamine agonists were more effective in the advanced stage of Parkinson's disease,pergolide was not only more effective,safe and tolerable,but also fewer adverse events than Bromocriptine was in this short term trial

Objective To investigate the effects of 810 nm semi-conductor laser irradiation on the proliferation of olfactory ensheathing cells in vitro. Methods Olfactory ensheathing cells obtained from adult rat olfactory mucosa using the method based on different rates of attachment were irradiated with a semi-conductor laser ( wave length 810 nm; power density 10.3 mW/cm2) for 30, 60 or 120 seconds. Laser irradiation was performed 3 times with a 24 h interval. After the last irradiation, the cells were cultured. At the 3rd, 5th and 8th day of cell culture,cell proliferation was assessed with cell counts and a methylthiazoletetrazolium ( MTT) colorometric method. Results After 3 days of cell culture, the number of cells and average MTT values showed no statistically significant difference between the irradiated and control groups. At the Sth and 8th day, the differences among all the laser exposure groups and with the control group were significant, except for the average MTT values of the control group and the 30 s exposure group. Maximal effect was achieved with a 60 s exposure. Conclusions Low power laser irradiation can stimulate the proliferation of olfactory ensheathing cells in vitro, and the effect is time-dose dependent. The optimal irradiation time was found to be 60 s daily for 3 times, with a 24 h interval.

Objective To investigate the association between gene polymorphism of sortilinrelated receptor 1 (SORL1) and Alzheimer' s disease by detecting a series of single nucleotide polymorphisms (SNPs).Methods The Snapshot method was used to genotypc 6 SNPs (SNP10,19,23,24,25,27) in SORL1 and the distributions of allele and genotype of the 6 SNPs were compared between AD patients and healthy control individuals.Results There were significant differences in the genotype distributions of SNP19,23,24 and 25 between AD patients and control group (all P＜0.01).Subjects with TT genotype in SNP19 had significantly lower risk for AD and was protective for AD (OR=0.089,95％CI:0.011-0.718,P＜0.01).The AT genotype in SNP23 (OR＝3.826,95％CI:1.388～10.544,P＜0.01),CT genotype in SNP24(OR=5.935,95％CI:1.774-19.853,P＜0.01)and CT genotype in SNP25(OR=5.754,95％CI:2.007-16.496,P＜0.01)had higher risks for AD.Conclusions SORL1 gene variants of SNP19,23,24 and 25 might be the important risk factors for late-onset AD.

Objective To compare the effect of freeze-thaw tumor cells and the supernatant from tumor cell culture on the activation of lymphocytes. Methods Malignant melanoma B16 cells were prepared as tumor cell vaccine and the supernatant from tumor cell culture was collected at different time point.Transwell method was used to determine the chemotaxis of lymphocyte attracted by freeze-thaw tumor cells and the supernatant from tumnor cell culture. The cytotoxic activity of lymphocyte was detected by CCK-8 method. Results Freeze-thaw tumor cells and the supernatant from more than 2 h of tumor cell culture were found to show chemotaxis of lymphocyte. The chemotaxis of tumor cell culture more than 4 h was stronger than freeze-thaw tumor cells. Each group of chemotactic lymphocytes demonstrated to have the activity of killing tumor cells. The ability of killing tumor cells induced by the tumor cell culture more than 4 h was stronger than that induced by freeze-thaw tumor cells.In a certain range,the ability of lymphocyte chemotaxis and activation were enhanced over time. Conclusion The chemotaxis and cytotoxic activation of lymphocyte induced by the supernatant from tumor cell culture for a certain time are stronger than those by freeze-thaw tumor cells. The supernatant from tumor cell culture can be used as tumor antigen to get better immune activation instead of the freeze-thaw tumor cells.

Objective To study the anti-tumor effects of mixed cultured B16 melanoma cells supernatant.Methods The supernatant from purely cultured B16 melanoma cells or mixedly cultured B16 melanoma cells with lymphocytes and macrophages at indicated time points were collected,respectively.The chemotaxis of the two different cell supernatants was determined by Boyden room method.The activation effects towards lymphocytes of the two different supernatants were determined by CCK-8 method.Results When the cells were mixed cultured for 0.5,1,2,4,8 and 12 h,the numbers of lymphocytes to travel from the upper well to the bottom well were (1.00±0.82) × 104,(7.00±1.63) × 104,(9.50±0.58) × 104,(11.25±2.36) ×104,(17.25±1.71) × 104 and (21.50±1.29) × 104,respectively.When the cells were purely cultured for 0.5,1,2,4,8 and 12 h,the numbers of lymphocytes to travel from the upper well to the bottom well were (0.00±0.00) ×104,(0.25±0.50) × 104,(1.75±0.96) × 104,(5.25±0.96) × 104,(5.75±1.26) × 104 and (10.75±3.20) × 104,respectively.The mixed cultured group showed higher chemotaxis effects towards lymphocytes in comparison with the purely cuhured one at the same points except for 0.5 h (P ＜ 0.05).The mixed cultured group showed higher activation effects towards lymphocytes in comparison with the purely cultured at the same points except for 0.5 and 1 h (P ＜ 0.05).Each group showed higher chemotaxis and activation effects towards lymphocytes when they were cultured for 12 h than the other time points (P ＜0.05).Conclusion The supernatant from mixed cultured cells shows much higher chemotaxis and activation effects towards lymphocytes to kill tumor cells.

Objective To investigate the safety and efficacy of technical modification for laparoscopic repair of giant hiatal hernias.Methods A total of 49 patients with giant hiatal hernia underwent modified laparoscopic repair by dissecting sac, closing hiatal, mesh placement and fundoplication from June 2010 to May 2014.The operation time, hospitalization time, postoperative complications, upper gastrointestinal imaging and improvement of postoperative symptoms were observed.Results The average operation time was (103.6 ±31.7) min(88-173min).The average length of post operation hospitalization was (4.2 ± 1.8) d (range,3-12d).Postoperative complication occurred in 4 patients,including pleural effusion (1 patient),respiratory failure (1 patient), difficulty in swallowing (2 patients)with complication occurrence rate being 8.2％ (4/49).No conversion or death occurred.The average time of follow-up was (28.3 ± 12.7) months (6-50 months) in 49 cases.During the follow-up, main symptoms were relieved and no recurrence was found by barium swallow.Conclusion Technical modification for laparoscopic repair of giant hiatal hernias is safe and effective.

Objective To understand the available preventive strategies of unplanned endotracheal extubation (UEX) among adult patients.Methods Twelve nurses were in-depth interviewed and data were processed and analyzed using categorization analysis method.Results Major themes were identified as follows:the incidence rate of UEX,tube fixation,efficacious physical restraint,appropriate sedation and training for younger nurses.Conclusions Nursing leaders should further standardize nursing process related to prevention of UEX,strengthen training for nurses,choose appropriate fixation method for patients and promote physical restraint and sedation care to prevent UEX and improve patient clinical outcomes.

Objective To investigate the correlation and clinicopathological features of ATAD2 and E-cadherin expression in human hepatocellular carcinoma (HCC),and role of ATAD2 in HCC cells invasion and metastases.Methods The expressions of ATAD2 and E-cadherin in 90 HCC specimens and 16 specimens collected from peritumoral tissue were detected by immunohistochemistry (IHC) test.The correlations between ATAD2 and E-cadherin expression and clinicopathological features were analyzed.The lentiviral vector of sh-ATAD2 RNA was used to interfere with ATAD2 expression.Western blot was performed to evaluate the changes of E-cadherin and Vimentin expression in HCC cells after ATAD2 expression interference.The role of ATAD2 in HCC cells invasion and metastasis was assessed by Transwell analysis.Results ATAD2 protein expression was obviously upregulated in HCC tissue compared to peritumoral tissue (56.7％ vs.31.3％,P ＜ 0.05).Meanwhile,E-cadherin expression was significantly downregulated in HCC tissue (43.3％ vs.68.7％,P ＜0.05).ATAD2 and E-cadherin expressions were both correlated with HCC metastasis (P ＜ 0.05).Correlation analysis demonstrated that the ATAD2 expression was negatively correlated with E-cadherin (r =-0.263,P ＜ 0.05).After interfering ATAD2 expression,cell migration and invasion of HCCLM3 cells were suppressed (migration,42.5 ± 2.6 vs.78.1 ± 3.8,P ＜ 0.05;invasion,33.0 ± 4.7 vs.72.7 ± 5.6,P ＜ 0.05).Meanwhile,the E-cadherin expression was remarkably upregulated (P ＜ 0.05).However,the Vimentin expression downregulated (P ＜ 0.05).Conclusions ATAD2 expression was upregulated in HCC,and silencing ATAD2 could upregulate E-cadherin expression and downregulate Vimentin expression,and inhibit the invasion and metastasis of HCC cells.Modulating E-cadherin expression may be the potential mechanism of ATAD2 in HCC invasion and metastasis.

Objective To investigate the safety and effectiveness of mesh and non-mesh techniques in laparoscopic repair of large hiatal hernias (LRLHH).Methods A retrospective clinical controlled study of mesh and non-mesh techniques in LRLHH form January 2006 to August 2014 was performed.Results A total of 83 and 36 patients were recruited to mesh and non-mesh group respectively.There were no significant differences in operation time,operation bleeding volume,hospitalization time or complications between the two groups.Main symptoms were significantly improved during the postoperative long-term follow-up in both groups.The improvement of dysphagia in mesh group showed no significant difference [22.9％ (19/83) VS 12.0％ (10/83),P=0.066],however,non-mesh group showed significant difference [30.6％ (11/36) VS 5.6％ (2/36),P=0.006].Rate of dysphagia alleviation in non-mesh group was significantly higher than that in mesh group [25.0％ (9/36) VS 10.8％ (9/83),P =0.048].Mesh-related complications of esophageal erosions occurred in 5 patients (6.0％) in mesh group,including esophageal stenosis in 3 patients,esophageal-cardiac stricture in 1 patient.Recurrent hernia occurred in 1 patient (1.2％) in mesh group and 3 patients (8.3％) in non-mesh group (P =0.082).Conclusion LRLHH with mesh should be individualized.The use of mesh in LRLHH reduces the recurrence rate,but may lead to some complications.

Objective To investigate and analyze the current status of adult unplanned endotracheal extubation in China,understand the preventive strategies of unplanned endotracheal extubation,and supply reference for future research.Methods All publications concerning unplanned endotracheal extubation from CBMdisc,CNKI and Wangfang Database were analyzed by establishing the reference manage and appraisal databases with Noteexpress and SPSS software.Results The publications concerning unplanned endotracheal extubation grew steadily year by year.The major study type was case series report(36.4％)followed by review(16.7％) and experience introduction(14.6％).Most literature focused on risk factors,preventing strategies,patients' outcomes and so on.Lacking of effective physical restraint and patients' anxious were the most common factors leading to unplanned endotracheal extubation.Conclusions Unplanned endotracheal extubation has got much attention from the clinical faculties recently.However,the domestic researchers focused on this topic lacked strict research design and efficient statistical methods.So it is imperative to develop the best practice information sheet for preventing unplanned endotracheal extubation by evidenced-based and scientific method.