Objective To evaluate the changes parameters of polysomnographic ( PSG) with different subtypes of primary Parkinson's disease ( PD ) and analyze the clinical characteristics of sleep disorders in PD patients. Methods Ninety patients with primary PD [ tremor-predominant PD group ( n = 40 ) , postural instability gait disorder ( PIGD )-predominant PD group ( n = 50 ) ] and 50 healthy controls were detected by full night PSG monitoring. And the results were compared. Results Compared with tremor-predominant PD group, the total sleep time, bed time, sleep wake-up times, sleep efficiency and rapid eye movement ( REM ) sleep time of PIGD-predominant PD group were significantly lower (all P<0. 05), however, the sleep latency, S1 (min), S1 (%), S2 (min), S2 (%), S3+S4(min), S3+S4 (%) had no statistical significance (all P>0. 05). Compared with the controls, the total sleep time and bed time of tremor-predominant PD group were significantly lower (all P<0. 05), however, the sleep wake-up times, sleep efficiency, REM sleep time, sleep latency, S1 ( min ) , S1 (%) , S2 (min), S2 (%), S3 + S4 (min), S3 + S4 (%) had no statistical significance (all P>0. 05). Combined with video surveillance video observation,the abnormality of REM sleep behavior disorder ( RBD) was 70% with PIGD-predominant PD group, in which the abnormality of tremor-predominant PD group was 2. 5%. Conclusions The PIGD-predominant PD patients are more likely to appear sleep disorders and RBD than tremor-predominant PD patients. It may be related to clinical heterogeneity of different PD subtypes.

Visfatin is a highly conserved protein expressed by visceral fat tissues that previously identified as pre B cell colony-enchancing factor (PBEF). Visfatin is a 52 ku cytokine and has been shown to exert multiple distinct biological activities. By interacting with insulin receptors, visfatin exhibits insulin mimicking or antagonizing effects under different circumstances. In addition, it possesses an nicotinamide phosphoribosyl transferase (Nampt) activity inside the cells, which functions at the rate-limiting step along the pathway of nicotinamide adenine dinucleotide (NAD) biosyntheses. And finally, as an extracellular cytokine, visfatin is able to induce the expression of inflammatory cytokines, such as TNF?, IL-1? and IL-6. Visfatin has drawn increasing attentions to researchers for its close association with a variety of human metabolic and acute/chronic inflammatory diseases or disorders, including diabetes, obesity, acute lung injury, rheumatoid arthritis, sepsis, myocardial infarction and inflammatory bowel disease. Recently, the SNP (single nucleotide polymorphism) analyses of visfatin and its promoter regions have provided more in-depth understandings of its roles in disease pathogenesis. A discussion in the current knowledge of the structure and diversified functions of visfatin, as well as its connections with a variety of common diseases was given.

OBJECTIVE To observe the bacterial biofilm formation on indwelling double J stent in the human body.METHODS A prospective study of 42 cases with double J stent indwelling in the human body after operation was conducted.The stent was divided into 4 segments then detected microbiologicaly in a separate manner and observed with scanning electron microscope for the presence of bacterial biofilm.RESULTS From 42 cases with douple J stent,only one case was without any bacteria in four segments.20 cases(47.6%) had the same bacteria in four segments.The bacterial positive rate of each segment was pelvic segment(81.0%),upper ureter segment(64.3%),lower ureter segment(71.4%) and bladder segment(83.3%);totally 18 kinds and 126 bacterial strains were flund.the most popular pathogens were Escherichia coli(23.0%),Pseudomonas aeruginosa(15.9%),corynebacterium(15.1%) and Staphylococcus epidermidis(13.5%).On the surface of unused double J stent,there was uneven but clean,without any attachment and encrustation,but on the surface of double J stent indwelling in the human body,the inflammatory affachment and encrustation were observed as well as bacterial biofilm,encapsulated in the abundant fibrous membrane.CONCLUSIONS Our study found that bacterial biofilm can be encrustated on the surface of double J stent indwelling in the human body,it may be one of the reasons for catheter-associated urinary tract infection.

Objective To investigate the antitumour effects of transfected gut-enriched Krüppellike factor(GKLF) on human gastric carcinoma cell line SGC-7901 in vitro and in vivo. Methods The expression of GKLF mRNA and protein in human gastric carcinoma cell line SGC-7901 were detected before and after transfection by real-time fluorescence quantitative PCR and Western blot,respectively. Proliferation and invasion in SGC-7901 were measured respectively by MTT assay, flow cytometry, colony formation assay and cell invasion assay after transfected with GKLF. The growth of xenograft was observed, the microvessel density(MVD) of xenograft tissue was determined by immunohistochemistry. Results The GKLF mRNA and protein in SGC-7901 were overexpressed after transfected with GKLF(P＜0.05). The proliferative speed of SGC7901-pcDNA3.1-GKLF group was markedly lower than that of SGC-7901 and SGC7901-pcDNA3.1 groups (P＜0.05). Transfected with GKLF caused part of the G0/G1 arrest, decreased clone formation rate and the invasion ability (P＜0.05). The growth speed of xenograft in SGC7901-pcDNA3.1-GKLF group was lower, the weight and MVD of xenograft tissue in SGC7901-pcDNA3. 1-GKLF group were less (P＜ 0. 05).Conclusion Transfected with GKLF maysuppress proliferation and invasion in human gastric carcinoma cell line SGC-7901, inhibit the growth and the angiogenesis of xenograft in nude mice.

Objective To investigate whether early goal-directed therapy ( EGDT ) could lower the mortality rate in patients with severe sepsis and septic shock. Methods Articles with items sepsis, severe sepsis, septic shock, EGDT were retrieved from MEDLINE, EMBASE, Cochrane, Wanfang Data and CNKI. Inclusion criteria included randomized controlled trial, subjects concerning patients with severe sepsis or septic shock, endpoints with short-term mortality [ in-hospital, intensive care unit ( ICU ) or 28-day ] and long-term mortality ( 60-day or 90-day ). Related risk ( RR ) and 95% confidence interval ( 95%CI ) were used as indices to judge the difference in mortality rate between EGDT group and standard treatment group. RevMan 5.2 software was used for Meta analysis. Results There were 8 studies meeting inclusive criteria with a total of 4 853 patients. For patients with severe sepsis and septic shock, compared with the group with routine treatment, EGDT showed a decrease in the short-term mortality ( RR = 0.74, 95%CI=0.66-0.82, P<0.000 01 ), but did not decrease the long-term mortality ( RR=0.99, 95%CI=0.92-1.06, P=0.81 ). Conclusion EGDT strategy may decrease the short-term mortality in patients with severe sepsis and septic shock, but it showed no influence on the long-term mortality.

Objective to investigate the level of platelet leukocyte aggregates in patients with acute cerebral infarction and their short term prognosis.Methods 105 patients with acute cerebral infarction onset within 24 hours were selected continuously,then platelet leukocyte aggregates including neutrophil aggregates (PNA) and platelet monocyte aggregates (PMA) and platelet lymphocyte aggregates (PlyA) were detected by flow cytometry within 24 hours of admission and the incidence of 14 days.modified Rankin Scale(mRS) was performed at 14 days of onset,as a prognostic indicator,and the mRS score was good at 3.The score >3 mRS was divided into poor prognosis.The level of platelet leukocyte aggregates was detected in 50 healthy subjects.Results (1) The platelet leukocyte aggregates in patients with acute cerebral infarction group were significantly higher than that of the healthy group,which was statistically significant (P<0.05).(2)MRs score <3 group and mRS score >3 score comparison,the difference of white blood cell aggregates was statistically significant(P<0.05).Conclusion leukocyte aggregates could be used as an index of short-term prognosis in patients with acute cerebral infarction.

In order to clarify the metabolism pathways of scandoside methyl ester, the analysis of metabolites profiling in four kinds of liver microsomes was performed by using an ultra-performance liquid chromatography/ electrospray-tandem mass spectrometry (UPLC-ESI-MS). The data obtained from the 0 h-incubation and the 2 h-incubation were compared and analyzed. After incubation, 5 metabolites of scandoside methyl ester were found in rat, Beagles, rhesus monkey and human liver microsome. The results showed that scandoside methyl ester's major metabolic pathway in the liver microsomes is hydrolysis, oxidation and reduction reactions, and there are certain kinds differences between species. The study provides a research base for further research about iridoid compounds in vivo metabolic pathways.

To identify the active components in Bufo melanostictus Schneider and clarify the difference between fresh and dried Venenum Bufonis, a UPLC-Orbitrap MS method has been established. The separation was performed with gradient elution of acetonitrile and water (with 0.1% formic acid) as mobile phase. By comparing their retention time and high resolution mass data of Venenum Bufonis extracts, 39 effective components were primarily identified by MS/MS analysis in positive ion mode. Twenty-six of them were bufadienolides. There were significant differences in the main composition between fresh and dried Venenum Bufonis. There are fewer bufadienolides in fresh toad venom.

Objective To investigate the influence and mechanism of erythropoietin (EPO) in renal blood flow after limb ischemia reperfusion (LIR). Methods Thirty male SD rats were randomly divided into control group, LIR group and EPO+LIR group with ten in each group. The values of renal blood flow, plasma creatinine (Cr), urea nitrogen (BUN) content in plasma, kidney tissue wet to dry ratio (W/D), nitric oxide (NO), nitric oxide synthase (NOS) and endothelin-1 (ET-1) in re-nal tissue were detected in three groups. The immunohistochemistry assay was used to detect the expression of intercellular adhesion molecule (ICAM-1) and vascular cell adhesion molecule (VCAM-1) in renal tissue. The morphological changes of renal tissue were observed with light microscope. Results The renal blood flow was significantly decreased, while the val-ues of Cr, BUN, W/D, NO, ET-1, NOS, expressions of ICAM-1 and VCAM-1 was significantly increased in LIR group than those of control group (P<0.05). Broaden interstitial and infiltration of inflammatory cells were observed in the renal tissue under light microscope. In the EPO+LIR group, the renal blood flow increased, the values of Cr, BUN, W/D, NO, ET-1 and NOS, expressions of ICAM-1 and VCAM-1 decreased significantly compared with those of LIR group (P<0.05). The patho-logical changes were alleviated in EPO+LIR group. Conclusion EPO can improve renal function, increase renal blood flow in rats after LIR. The mechanism may be related to the decreased edema, changed renal vasomotor function and decreased in-flammation.

Objective To investigate the clinical value of dynamic glucose monitoring in the middle and late pregnant women with diabetes mellitus,and the related clinical and nursing measures.Methods One hundred admitting cases of the middle and late pregnant women with diabetes mellitus were grouped according to the random number table,50 cases of the control group were treated with finger tip blood glucose monitoring and conventional treatment,50 cases of dynamic blood glucose monitoring and comprehensive clinical and nursing intervention for the observation group.The blood glucose control situation with different time,the incidence of hypoglycemia,the actual control range of the glycosylated hemoglobinblood and the length of hospital stay and so on were evaluated in two groups.Results The incidence of hypoglycemia in the observation group was 6.0％ (3/50),the control group was 24.0％ (12/50),the difference was statistically significant (P ＜ 0.05).In the early morning,after breakfast 2 h,before and after lunch 2 h,before and after dinner 2 h and before bed and other different time,the blood glucose level with the observation group was lower than that in the control group (P ＜ 0.05).At the same time,in the blood glucose effective controlling time,hospitalization time,the observation group was better than the control group (P ＜ 0.05).The blood glucose level and the detection range of the glycosylated hemoglobin were also detected in the safe state for outpatient follow-up after hospital discharge.Conclusions The intervention of dynamic blood glucose monitoring and comprehensive clinical and nursing measures in middle and late pregnant women with diabetes mellitus is conducive to control blood glucose level timely and accurately and to improve their prognosis.It is the key to the success of the future obstetric prevention and diagnosis and treatment of the disease,and is recommended clinical popularization.