Objective To explore the clinical characteristics and prognostic factors in patients with Parkinson's disease (PD) and excessive daytime sleepiness (EDS) and to identify whether EDS could influence the sleep architecture and sleep apnea-related parameters.Methods A total of 130 PD patients were eligible and enrolled in the study.By the Epworth sleepiness scale (ESS),patients were divided into the EDS group (ESS ≥ 10) with 61 patients and the non-EDS group (ESS ＜ 10) with 69 patients.All underwent a video-polysomnography (PSG).Clinical characteristics were mainly evaluated by the unified Parkinson's disease rating scale (UPDRS) and the Hoehn-Yahr(H-Y) stage.while other related scales were applied for evaluating depression,cognitive function,quality of sleep and quality of life.Results A total of 61 patients (46.92％) were diagnosed as EDS (ESS≥ 10).Compared to the non-EDS group,the EDS group had significantly higher score of HAMD,UPDRS Ⅰ and UPDRS Ⅱ,and significantly lower score of MoCA and PDQ (all P ＜ 0.05).Non-conditional logistic regression analysis showed that the scores of HAMD and UPDRS Ⅰ were the main prognostic factors for EDS.Significantly decreased sleep latency (SL) was found in the EDS group by PSG (P =0.008).The score of ESS was showed to be correlated with the scores of HAMD,MoCA,UPDRS Ⅰ,UPDRS Ⅱ,PDQ and SL.Conclusions PD patients with EDS have more severe depression and cognitive dysfunction and worse quality of life.Sleep structure is altered in those patients with decreased sleep latency.Mental status is closely associated with EDS,but not sleep apnea.

Objective To discuss the application effects of fast track surgery treatment in hysterectomy. Methods 120 patients underwent hysterectomy. They were randomly assigned to two groups,namely,fast track sur-gery group(60 cases) and control group(60 cases ). two groups underwent separately fast track surgery mode and tradi-tional mode therapy. To observe the duration of passing flatus, the hospital stay, the aching time, the complication rate after operation between two groups. Results All patients got recovery. The duration of passing flatus(29.2±7.9) h,the aching time 96.7% (58/60)、the hospital stay( 3.9±2.5 )d of fast track surgery group were significantly shorter than the duration of passing flatus (50.3±15.8 ) h 、the aching time 8.3% (5/60)、the hospital stay (6.7±2.8 ) d of control group( allP<0.01 ). there was no severe complication in two groups. Conclusion Fast track surgery treat-ment mode could accelerate postoperative rehabilitation of hysterectomy patients. It shoud be popularized.

Objective To analyse the clinical characteristics of male hypogonadotropic hypogonadism.Methods Clinical data of 87 cases of male hypogonadotropic hypogonadism were retrospectively analyzed.Results Mean age was(18.8?4)years old,and 25 patients were diagnosed as Kallman syndrome.The level of serum LH,FSH,and T was low,and LH responded poorly to GnRH stimulation.Most patients' bone age was delayed,and all patients' CT or MRI of pituitary was normal.Conclusion According to the above clinical features,and testosterone replacement or hCG and/or plus hMG are the choice of treatment.

This article summarizes specific ethical doctrines from the traditional ancient Indian medicine, analyzes the characteristics of its ethical thought, absorbs its reasonable essence, pays great attention to the dual function of medical technique and medical ethics in current medical activities, highlights the importance of cooperation under the modern medical service condition, and emphasizes the application of etiquette in medical activities.

To provide more objective basis for traditional Chinese medicine (TCM) syndrome differentiation of deficiency and excess by collecting and analyzing voice signals and extracting characteristic parameters.

Aim To study the protective effects of Paeoniflorin (PF) on dopaminergic neurons in brain slice of substantia nigra treated with MPP~+ and to investigate the transcription of alpha-synuclei (α-syn) mRNA.Methods The organatypic brain slice culture of substantia nigra prepared from neonatal SD rats was placed on Millicell-CM porous membranes and cultured to day-10.Then the cultrues of slice were treated with different concentrations (0.1,0.5,1.0 mmol·L~(-1)) of MPP~+ for 24 h.Some of the cultrues treated with 0.5 mmol·L~(-1) MPP~+ also received PF (1 or 10 μmol·L~(-1)).Slices cultured in normal medium were used as vehicle control.The tyrosine hydroxylase (TH) immunohistochemical staining with the cell counting was used to determine the dopaminergic neruons.The transcription of α-syn mRNA was examined by real-time quantitative RT-PCR.Results MPP~+(0.1,0.5,1.0 mmol·L~(-1)) exposure markedly decreased the number of TH~+ cells in a dose-dependent manner (P<0.05 or P<0.01) and sharply induced the transcription of α-syn mRNA (P<0.01) in slices treated with 0.5 mmol·L~(-1) MPP~+.The addition of PF (10 μmol·L~(-1)) to MPP~+-treated slices significantly increased dopaminergic neurons survival (P<0.01) and downregulated the transcription of α-syn mRNA significantly (P<0.05).Conclusion PF can effectively inhibit the injury of dopaminergic neurons induced by MPP~+ on brain slice of substantia nigra and downregulate the transcription of alpha-synuclein.

Objective To explore the effects of isokinetic training on muscle endurance and the ambulatory capacity of patients with incomplete lumbar spinal cord injury ( SCI ) . Methods Sixty patients were randomly divided into a control group and a treatment group, each of 30. Both groups were given conventional rehabilitation, while the treatment group was additionally provided with isokinetic muscle strength and muscle endurance training for 3 months. The endurance ratio ( RO) of the quadriceps and hamstrings, the mean power frequency of the rectus femo-ris (RF-MPF) and the biceps flexor cruris (BF-MPF), and distance covered in the 6-minute walk test (6MWT) were evaluated before and after the treatment. An index of functional community ambulation was also compared be-tween the 2 groups. Results After the treatment significant differences were observed in all of the measurements compared to before the treatment for both groups. The average RO improvement of the quadriceps and hamstrings, the BF-MPF, the RF-MPF and the 6MWT distance of the treatment group were all significantly higher compared with the control group. After the treatment, 25 patients of the treatment group could demonstrate functional community ambula-tion, significantly better than that of 20 of the control group. Conclusion Isokinetic training can improve muscle endurance and the walking capacity of persons with an incomplete lumbar spinal cord injury.

Objective To investigate risk factors and prognosis of hemorrhagic transformation(HT)in acute cerebral infarction patients treated by intravenous thrombolysis with recombinant tissue plasminogen activator(rt-PA).Methods All 128 patients with acute cerebral infarction were treated with intravenous rtPA within 6 hours from stroke onset.The clinic records and laboratory datas of pre-and post-treatment were statistically analyzed between HT group and non-HT group to find potential risk factors to HT and contributors of prognosis.Results HT occurred in 29 patients(22.66％),including 16 patients with symptomatic ICH(12.50％)and 2 patients died(6.90％ of HT).Logistic regression analysis showed that history of atrial fibrillation(OR =1.293,95％ CI 1.224-1.589,P =0.001),CT density changes with mass effect or edema(OR =2.452,95％ CI 1.132-3.309,P =0.034),diastolic blood pressure ≥ 100 mm Hg before thrombolytic therapy(1 mm Hg =0.133 kPa,OR =9.265,95％ CI 1.435-59.836,P =0.019),blood glucose ≥ 11.1 mmol/L(OR =3.037,95％ CI 0.252-57.593,P =0.047),NIHSS score ＞ 15 points (OR =8.752,95％ CI 1.035-30.285,P =0.023)and thrombolysis time ＞ 3 h(OR =98.74,95％ CI 5.067-186.120,P =0.002)are independent risk factors for HT; among these factors,baseline blood glucose(OR =3.265,95 ％ CI 0.435-59.863,P =0.045),NIHSS score(OR =10.453,95 ％ CI 5.647-38.185,P =0.003)and thrombolysis time(OR =2.541,95％ CI 1.098-51.086,P =0.017)also are prediction factors of the prognosis of HT.Conclusion Risk factors associated with HT are diastolic blood pressure before thrombolysis,glucose level,degree of neurological deficits,CT early changes,atrial fibrillation and thrombolytic time.Glucose level,neurological deficits and thrombolysis time affects the prognosis of patients.

BACKGROUND: 6-hydroxydopamine, as an endogenous toxic factor in the pathogenesis of Parkinson's disease, participates in oxidative stress. N-acetylcysteine resists oxidation and removes free radicals effectively.OBJECTIVE: To investigate the toxicity of 6-hydroxydopamine in bone marrow stromal cells and the antagonistic effect of N-acetylcysteine on it. METHODS: Bone marrow stromal cells of Sprague-Dawley rats were cultured in vitro. Bone marrow stromal cells of passage 3 were treated with 6-hydroxydopamine with the final concentrations of 0,0.05,0.1g/L and N-acetylcysteine with the final concentrations of 0, 0.075,0.3,1.2,4.8g/L, respectively.RESULTS AND CONCLUSION: MTT assay showed that 6-hydroxydopamine (0.05 and 0.1 g/L) significantly decreased the viability of bone marrow stromal cells. This toxic effect of 6-hydroxydopamine was significantly inhibited by 0.3 g/L N-acetylcysteine. It suggests that antioxidant N-acetylcysteine may affect the toxic action of 6-hydroxydopamine.

To investigate the relationship among serum vascular endothelial cells(VE) -cadherin, advanced glycation end-products( AGE), and atherosclerotic lesion. 20 healthy subjects and 60 patients with diabetes mellitus,including 30 patients with carotid atherosclerosis (CI), were enrolled.Soluble VE-cadherin and AGE were determined using the enzyme-linked immunosorbent method (ELISA). The relationships among the concentration of soluble VE-cadherin, AGE, and the course of the disease, blood glucose, and blood lipid levels were analyzed with multivariant stepwise regression analysis. The levels of serum VE-cadherin and AGE in the patients with diabetes and CI were higher than those in control group( P＜0. 05 ). There was a significant difference in VE-cadherin between the diabetes group and the CI group( P＜0. 05 ). Serum VE-cadherin levels were positively correlated with serum AGE levels(r = 0. 69, P＜0. 01 ). AGE levels were positively correlated with the diabetes duration ( r = 0. 31, P =0. 02 ). The levels of serum VE-cadherin in diabetic patients are positively correlated with their serum AGE levels. The VE-cadherin seems to play an important role in the development of atherosclerosis caused by AGE.