ObjectiveTo understand the clinical characteristics and therapy of Huntington's disease (HD).MethodsThe clinical characteristics of five typical kindreds with HD were analysed. The therapeutic progression after reviewing literature was summarized.ResultsFive kindreds inherited in an autosomal dominant manner. They were all adult-onset HD.Progressive motor dysfunction,cognitive decline,emotional and behavioral disturbance were the key clinical presentations. At an early stage, manifestations include subtle emotional symptoms and involuntary movements.The reason of visiting doctor was chorea. CT scans demonstrated brain atrophy.ConclusionsTypical clinical manifestation and clear family history may be enough to make primary diagnosis. Psychological evaluation at risk individual may help to diagnose early. Gene testing may confirm the diagnosis of HD. The drugs and occupational,physical therapy and psychotherapy for HD patients can help maintain the highest level of function and improve the quality of life.

Through field observation and in -depth interviews of H County , analyzed about the present multidi-mensional situation between patient and physician .This paper discussed villager autonomy environment barriers and village village system build trust between patient and physician′s interpersonal trust between patient and physician′s unique features , further improve the village of doctor -patient trust countermeasures and suggestions: strengthen the village doctor training;To strengthen the village doctor in performance appraisal of public welfare goal , consoli-date the village-level emotional trust between patient and physician; Establish differential income compensation mechanism , arouse the enthusiasm of the village doctor service , and improve the level of village -level doctor-pa-tient trust .

Objective:To compare the similarities and differences of doctor -patient trust building mechanism between doctors in urban and rural areas from the perspective of rural residents by the empirical study .Methods:Based on the field research and secondary in -depth interviews to the related personnel in H County of Beijing .Re-sults:There had obvious difference of doctor -patient trust building mechanism between doctors in urban and rural areas from the perspective of rural residents .Trust building mechanism between village doctors were mainly the trust of the similar social background , between the doctors in township health centers and city hospital were the trust based on reputation , institution-based trust , and relationship-based trust .Conclusion:The difference of re-gional and cultural between urban and rural areas ,the nature of medical institutions the relationship with doctors , reputation of medical institution and medical and health care system in urban and rural areas ,maybe the reasons that The difference of doctor -patient trust building mechanism between doctors in urban and rural areas .

This study aimed to identify Inulae Herba, Inulae Flos and their closely related species using the ITS2 bar-code, and secure the quality and clinical curative effect of these medicinal materials. DNA was extracted from Inula linariifolia, I. japonica, I. britanica, which are the original species of Inulae Herba and Inulae Flos, together with their closely related species. The ITS2 sequence was amplified by PCR and sequenced bidirectionally. Sequence assembly and generation of consensus sequence were conducted by the CodonCode Aligner. The genetic distances were comput-ed using MEGA 5.0 in accordance with the Kimura-2-parameter (K2P) model, and the phylogenetic tree constructed by the neighbor-joining (NJ) method. The results showed that the ITS2 sequences of the various species have stable variable sites. The intraspecific genetic distances among Inulae Herba and Inulae Flos were obviously lower than the interspecific genetic distance among the above two medicinal materials and its adulterants. The NJ tree based on ITS2 sequences can clearly differ from Inulae Herba, Inulae Flos and their closely related species. It is concluded that ITS2 sequence can be used as DNA barcode to identify Inulae Herba, Inulae Flos and their closely related species.

Objective: To prospectively investigate the feasibility of shear wave elastography (SWE) as a new quantitative and objective method for evaluating the stiffness of the gastrocnemius medialis (GM) muscle during passive stretching in patients with Parkinson’s disease (PD). Materials and Methods: SWE of the GM muscle was performed in 28 patients with PD [13 female and 15 male; mean age ± standard deviation (SD): 63.0 ± 8.5 years] and 12 healthy controls (5 female and 7 male; mean age ± SD: 59.3 ± 6.4 years) during passive ankle rotation. A Young’s modulus-ankle angle curve was constructed. The GM slack angle and baseline Young’s modulus (E 0) were compared between the markedly symptomatic and mildly symptomatic sides of patients with PD, and healthy controls. Additionally, the correlation between the GM slack angle and the severity of rigidity, and the observer reproducibility of SWE in determining the GM slack angle were evaluated. Results: The GM slack angle was smaller on both the markedly and mildly symptomatic sides in patients with PD than in healthy controls (mean ± SD of -29.13° ± 3.79° and -25.65° ± 3.39°, respectively, vs. -21.22° ± 3.52°; p < 0.001 and p = 0.006, respectively). Additionally, in patients with PD, the GM slack angle on the markedly symptomatic side was smaller than that on the mildly symptomatic side (p = 0.003). The E 0 value was lower on both the markedly and mildly symptomatic sides in patients with PD than in healthy controls (mean ± SD of 10.11 ± 2.85 kPa and 10.08 ± 1.88 kPa, respectively, vs. 12.23 ± 1.02 kPa; p = 0.012 and p < 0.001, respectively). However, no significant difference was found between the markedly and mildly symptomatic sides in patients with PD (p = 0.634). A negative linear relationship was observed between the GM slack angle and lower limb rigidity score on the markedly symptomatic side in patients with PD (r = -0.719; p < 0.001). The intraclass correlation coefficients for observer reproducibility of SWE ranged from 0.880 to 0.951. Conclusion The slack angle determined by SWE may be a useful quantitative and reproducible method for evaluating muscle stiffness in patients with PD.

Objective: To isolate and identify the undescribed compounds from the fruits of Cinnamomum migao and evaluate its nitric oxide inhibition potential. Methods: The chromatographic techniques of silica gel, Sephadex, and HPLC were used for isolation and purification of the compounds, while HR-ESI-MS, 1D NMR, 2D NMR, ECD, and X-ray diffraction techniques were used to characterize and confirm the isolated compounds. Moreover, the anti-inflammatory activity of the isolated compounds was carried out to check inhibitory potential against the production of nitric oxide with RAW264.7 cells stimulated by LPS. Results: Camganoid A (1), a novel sesquiterpene possessing an unprecedented skeleton, and camganoid B (2), containing a unique eight-membered sesquiterpene moiety with a new carbon skeleton, were isolated and identified from the fruits of C. migao. The absolute configurations of 1 and 2 were confirmed by single crystal X-ray diffraction and electronic circular dichroism (ECD) calculations. Among these compounds, compound 1 exhibited potent inhibitory activity against the production of nitric oxide with IC

Objective To explore the relationship between the polymorphism of catechol-O-methyltransferase (COMT) gene Val158Met site and depression in Parkinson's disease. Methods From June, 2016 to December, 2017, a cohort of 268 Chinese patients with Parkinson's disease and 252 age- and gender-matched healthy control subjects were recruited. The patients were divided into depression group (n=116) and non-depression group (n=152) according to Hamilton Depression Scale score. Their blood samples were collected and the polymorphism of Val158Met was carried out using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results No difference was identified in Val158Met polymorphism of genotype (χ2=0.78, P>0.05) and allele (χ2=0.25, P>0.05) among the depression group, the non-depression group and the control group. Conclusion The polymorphism of Val158Met in COMT gene does not contribute to the risk of depression in Parkinson's disease in China.

Objective To compare the characteristics of the tremor of multiple system atrophy Parkinsonism type (MSA-P) with Parkinson's disease (PD), and improvement after acute levodopa challenge test. Methods From Match to September 2017, 70 patients with PD and 23 patients with probable MSA-P were included. All the patients were required of rest or postural tremor in at least one extremity or head, and accepted acute levodopa challenge test and analysis for dominant tremor frequency, amplitude and rhythm under resting state, posturing and holding 1000 g state, respectively.Results The score of Unified Parkinson Diease Rating Scale Part III was higher in MSA-P patients than in PD patients (t=-2.098, P<0.05), with less improvement after acute levodopa challenge test (Z=-9.446, P<0.01), while the tremor score and improvement were not significantly different between two groups (P>0.05). There were more frequence with non-alternating or synchronic tremor rhythm (χ2=8.756, P<0.01) and small irregular tremor in rest tremor (χ2=4.788, P<0.05) in MSA-P patients than in PD patients, as well as the high frequency tremor (>6 Hz) in postural tremor (χ2=11.312, P<0.01). The frequency of rest tremor was higher in MSA-P patients than in PD patients (t=-2.119, P<0.05), as well as the frequency of postural tremor with 1000 g (t=-2.274, P<0.05). Both PD and MSA-P patients showed, the lower frequency the postural tremor was, the higher the tremor scores were. There were 25% PD patients with head tremor, while none in MSA-P patients. Tremor score improved more than 30% after acute levodopa challenge test in 22.7% MSA-P patients, but none improved in UPDRS score. The frequence of tremor score improvement was more in female MSA-P patients than in males (P<0.05).Conclusion The features of the tremor are similar in PD and MSA-P, with some differences that MSA-P tend to higher frequency in rest or postural tremor, more non-alternating or synchronic tremor rhythm in rest tremor, and fewer has tremor besides limbs. Some MSA-P patients improve after acute levodopa challenge test, and women may improve more than men.

OBJECTIVE: To isolate the phenolic amides from the dried bulbs of Allium chinense and investigate their myocardium protective activities. METHODS: The chemical constituents were isolated and purified by combining with silica gel column, Sephadex LH-20 column, HPLC and other chromatography techniques. Their structures were elucidated by NMR techniques and mass spectrometry. The isolated compounds were evaluated to determine their protective effect for myocardium cells in vitro. RESULTS: Two new phenolic amides, namely, alichinemide I ( 1) and alichinemide II ( 2), and six konwn amides were isolated from the dried bulbs of A. chinense. The structures of compounds 3- 8 were identified as 3-indolcarbaldehyde ( 3), 1-(2-aminophenyl)urea ( 4), 2,3,4,9-tetrahydro-1H-pyrido[3,4-b]indole-3-carboxylic acid ( 5), N-trans-feruloyltyramine ( 6), N-trans-p-coumaroyltyramine ( 7), and N-(3,4-dimethoxyphenethyl) acetamide ( 8). Compound 3 (50 μmol/L) showed significant inhibitory effect on the damage of H9c2 myocardial cells induced by H₂O₂in vitro. CONCLUSION Compounds 1 and 2 were new phenolic amides. Compound 3 could be one of the potential myocardium protective constituents of A. chinense.

Objective To report a novel case of hereditary spastic paraparesis type 11 (SPG11) first presenting as juvenile Parkinsonism. Methods A 27 years old man first attack at 13 years old was reviewed. Results Parkinsonism-like features, such as tremor, rigidity, bradykinesia and gradually difficulty walking, were complained, and responded to dopaminergic therapy. MRI showed thin corpus callosum and hyper-intense T2WI lesions in periventricular regions. His nerve conduction velocity was normal. Genetic analysis detected two novel mutations, named c.5867-1G>C and c.3687-2A>G, in spastic paraplegia gene 11, which came from his father and mother separately. Conclusion Parkinsonism may be the inaugural presentation of SPG11, and a genetic test may be needed for the child with juvenile Parkinsonism.