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.

Clear thermoplastic retainer is one of the most commonly used retention devices in orthodontics.However, studies about the electromyography (EMG) of temporalis muscle (TM) and masseter muscle (MM) in people with clear thermoplastic retainer are few. The purpose of this study was to observe the influence of clear thermoplastic retainer on the EMG of TM and MM in mandible posture position (MPP) , speaking [s] ,[z] and [a]. Choose people according to the standards, decide the situation by preliminary experiment. The EMG of TM, MM was studied before and after clear thermoplastic retainer was worn. Variance analysis was used to evaluate the differences. The results revealed that the EMG activity of TM?MM, viewed in MPP and when people said [s] ,[z] , was higher after clear thermoplastic retainer was worn. When people said [a], there was no significant difference.

Objective To characterize the changes of retinal structure and visual field mean defects (MD) in early Parkinson's disease (PD) and the related factors.Methods Twenty-five patients with early stage PD and 33 normal controls were enrolled in this study.PD patients were evaluated by unified Parkinson's disease rating scale (UPDRS) and Hoehn-Yahr (H-Y) stage in off period.All subjects undertook retina of retinal nerve fiber layer (RNFL) and macular examinations by optical coherence tomography (OCT),and MD by automatic visual field analyzer.Results (1) The average thicknesses of RNFL and C11 quadrant RNFL were thinner in PD group [(96.2 ±7.6) μm and (124.4 ± 18.4) μm] than in healthy controls [(102.6 ± 5.0) μm and (135.4 ± 21.8) μm,respectively,P =0.000 and P =0.047].Moreover,PD patients had a thinner average thickness of macular[(277.2 ±9.6) μm vs (285.8 ± 12.6)μm,P=0.006],and smaller macular volume compared with controls [(10.0 ± 0.3) mm3 vs (10.3 ±0.4) mm3,P =0.006].However,there was no significant difference in MD between PD and control subjects [(0.43 ± 2.75) dB vs (-0.18 ± 1.41) dB,P =0.322].(2) Pearson's correlation analysis showed that H-Y stage was negative correlated with the average RNFL thickness (r =-0.569),average macular thickness and volume (r=-0.501 and r=-0.417) in PD patients (all P＜0.05).Conclusions PD patients have thinner average thicknesses of RNFL,C11 quadrant RNFL and macular,smaller macular volume than those in normal controls.There were no significant differences in MD between two groups.There were negative relationships between H-Y stage,and retinal thickness and volume of PD patients.

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 investigate the characteristics of the objective sleep disturbances in Parkinson' s disease (PD) and the factors related to it.Methods One hundred and one PD patients and 90 age- and sex- matched controls underwent a video-polysomnography.The sleep parameters and its related factors in two groups were analyzed.Results Sleep latency was not statistically different in comparing two groups.PD patients had a higher percentage of non-rapid eye movement( non-REM ) sleep stage 1 and a lower percentage of non-REM sleep stage 2 compared with controls ( 27.9 ± 1 7.8 vs 21.2 ± 11.7,t =3.034,P =0.003 ;47.8 ± 17.4 vs 54.7 + 12.9,t =- 3.043,P =0.003 ).Reduced sleep efficiency,decreased the proportion of slow wave sleep and REM sleep,increased awake time and longer REM sleep latency occurred in PD patients.There were no significant differences of these above parameters.Some sleep parameters in PD patients were correlated with advancing age,the severity of PD,and the degree of depression.The index of periodic leg movements in sleep (PLMSI) of 41 PD patients (40.6％ ) was more than 15.These PD patients didn' t complain corresponding symptoms about their legs.The PLMSI in PD patients were significantly higher than the controls.PLMSI increased with aging in the PD group( r =0.261,P ＜0.01 ).PD patients didn' t suffer significantly lower apnea- hypopnea index and oxygen desaturation index.The lowest SPO2 ( L-SPO2 ) increased in the PD group.REM sleep without atonia occurred in 83 patients (82.2％) with PD.Thirty-eight patients (37.6％) were diagnosed with REM sleep behavior disorder (RBD).The incidences of REM without atonia and RBD in the PD group were significantly higher than in the control s(0 and 8 patients (8.9％),x2 =42.271,102.480; both P ＜ 0.01 ).Conclusions The sleep parameters in PD patients are changed.For PD patients,there is no difficulty in falling asleep.The PD patients also have sleep structure disorder and difficulty in maintaining sleep.The sleep parameters are correlated with advancing age,the severity of PD,and the degree of depression in PD.PLMS don' t lead to sleep disturbances in PD patients.The blood oxygen saturation don' t decrease severely when PD patients suffer apnea or hypopnea.RBD occur more frequently in PD patients.

Objective To investigate the effects of sevoflurane pretreatment on the inflammatory response in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB) and the mechanism of myocardial protection.Methods Twenty NYHA class Ⅱ or Ⅲ patients of both sexes,aged ＜ 60 yr,undergoing cardiac valve replacement with CPB,were randomly divided into 2 groups (n=10 each): sevoflurane group (group S) and control group (group C).The patients were premedicated with intramuscular morphine 0.1 mg/kg and scopolamine 0.3 mg.Anesthesia was induced with iv injection of midazolam 0.05-0.08 mg/kg,fentanyl 10-15 μg/kg and pipecuronium 0.08-0.10 mg/kg.The patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with intermittent iv boluses of midazolam0.03-0.06 mg/kg,fentanyl 5-10μg/kg and pipecuronium 0.04-0.08 mg/kg.Sevoflurane was inhaled before aortic clamping and the end-tidal concentration was rapidly adjusted to 1.0％ and maintained at this level for 30 min in group S.Blood samples were taken from the central vein before skin incision,immediately after aortic clamping,immediately after aortic unclamping and at 30 min after aortic unclamping,at 2,6,12 and 24 h (T1-8) after operation for determination of the concentrations of plasma tumor necrosis factor-α (TNF-α),interleukin-6 (IL) and interleukin-8 (IL-8),intercellular adhesion molecule-1 (ICAM-1),cardiac troponin I (cTnI) and activity of creatine kinase MB (CK-MB).The requirement for cardiovascular drugs was recorded after release of aortic cross clamp.Results Compared with group C,the plasma concentrations of TNF-α,IL-6 and IL-8 were significantly decreased at T3-8,the plasma concentrations of ICAM-1 and cTnl were significantly decreased at T4-8,the activity of plasma CK-MB was significantly decreased at T8,and the requirement for cardiovascular drugs was significantly reduced after release of aortic cross clamp in group S (P ＜0.05).Conclusion Sevoflurane pretreatment can inhibit the inflammatory response and provide myocardial protection to some extent in patients undergoing cardiac valve replacement with CPB.

Cancer patients complicated with venous thromboembolism (VTE) face treatment problems, very high recurrence rate and bleeding rate. Cancer itself and the antitumor treatment plan are the important factors causing the recurrence. After the relapse, the prognosis of the patients is extremely bad, and more than 50% of the patients died within 1 year. Until now, there is no unified effective treatment plan for the relapse. This paper reviews the recurrence of VTE and the related research progress.

Objective To investigate the effects of sevoflurane pretreatment on the myocardial injury in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Twenty NYHA class Ⅱ or Ⅲ patients,aged ＜ 60 yr,undergoing cardiac valve replacement with CPB,were randomly divided into 2 groups (n =10 each):sevoflurane group (group S) and control group (group C).The patients were premeditated with intramuscular morphine and scopolamine.Anesthesia was induced with iv injection of midazolam 0.05-0.08 mg/kg,fentanyl 10-15 μg/kg and pipecuronium 0.08-0.10 mg/kg.Anesthesia was maintained with intermittent iv boluses of midazolam,fentanyl and pipecuronium and in addition sevoflurane was inhaled before aortic clamping and the end-tidal concentration was rapidly increased to 1.0％ and maintained at the level for 5 min in group S.Blood samples were taken from the central vein before skin incision (T1),immediately after aortic clamping (T2 ),at 0 and 30 min after aortic unclamping (T3-4),and at 2,6,12 and 24 h after operation (T5-8) for determination of the concentration of serum cardiac troponin Ⅰ (cTnI) and activities of creatine kinase (CK) and creatine kinase isoenzyme-MB (CK-MB).Myocardial specimens were taken from right auricle before aortic clamping and at 10 min after aortic unclamping for electron microscopic examination.Results The concentration of serum cTnI and activities of CK and CK-MB were significantly increased at T4-8 in both groups ( P ＜ 0.05).The serum cTnI concentration at T4-8 and the activities of CK and CK-MB at T8 were significantly lower in group S than in group C ( P ＜0.05).Different degrees of mitochondrial swelling were observed after aortic unclamping in both groups,but the changes were milder in group S than in group C.Conclusion Sevoflurane pretreatment can attenuate the myocardial injury in patients undergoing cardiac valve replacement with CPB.

Objective To investigate the interactive effects between batroxobin and low molecular weight heparin(LMWH)in reducing peri-operative blood loss and coagulation function in patients who undergone the total hip replacement surgery. Methods 240 ASA Ⅰ-Ⅲ patients received 4 000 IU LMWH 12 hours preoperatively before undergoing the total hip replacement operation,were randomly divided into two groups:testing group (Group A,n=120) and control group(Group B,n=120)receiving 2 U batroxobin or 50 mg mannitol 10 minutes before incision respectively. Perioperative blood loss,postoperative 24 hours drainage and blood routine test, prothrombin time (PT),activated partial thromboplastin time(APTT) and fibrinogen(FIB) were measured respectively. Deep vein thrombosis (DVT) were measured through color Doppler B-ultrasound 3 days after the operation. Results The perioperative blood loss in Group A (422.64 ml)was less than that in Group B(667.67 ml)(P<0.01)while red blood cell,hemoglobin, red blood cell volume and platelet were decreasing after operation in both groups but no significant difference was found between the two groups(P>0.05). There were no drug-related adverse effects found in the two groups,neither the difference in hospitalization between the two groups(P>0.05). Conclusion Batroxobin (2 U) could reduce the perioperative blood loss in patients with LMWH who had undergone the total hip replacement operation but did not show adverse effect on DVT.

Objective: To analyze the clinical response in cases of multi-victims bitten by a dog in Beijing (one of whom was HIV positive), and to explore the route and prognosis of dual exposure to rabies virus and HIV. Methods: Descriptive epidemiological methods were used to analyze the exposed cases, the post-exposure prophylaxis(PEP) of rabies and HIV and the follow-up outcomes. Results: After six months-follow up, there was no rabies case was found among those nine victims bitten by the suspected dog. In addition, six HIV-negative victims who had been exposed to HIV via dog saliva were consistently tested to be HIV negative in the follow up period. Conclusions In cases with multi-victims bitten by one dog, except exposure to rabies virus, it is necessary to be alert to the presence of HIV, HBV or HCV infection in sequential victims. Therefore, the risk of the potential spreading of other blood-borne infectious pathogens should be assessed. It is important to initiate PEP as early as possible.