Objective To study ocular motor function in patients with Parkinson disease.Methods Videonystagmography(VNG)was used for testing ocular saccade and smooth pursuit eye movement(SPEM)in 14 patients with idiopathic Parkinson disease and 10 age and sex-matched control subjects to compare the latency of saccades,the accuracy of saeeades and SPEMGain between two groups. Results The latency of saceades was found to be much more increased in PD group (291.23±46.25)ms than that in healthy group(244.45±23.11)ms(P＜0.05);and the accuracy of saccades was found to be decreased in PD group(87.98±6.1 6)as compared to that in healthy group (95.21±8.56)(P＜0.05).PD group was found to have more decreased SPEM gain(0.81±0.12)than that in healthy group(0.90±0.1 5)(P＜0.05). Conclusions The findings suggest that ocular motor function is abnormal in Parkinson disease patients.

Objective To study the incidence of rapid eye movement sleep behavior disorder (RBD) and its impact on the clinical manifestations of patients with Parkinson' s disease (PD). Methods One hundred and twenty-four PD patients were included into this study and each of them was given the non motor symptoms questionnaire (NMSquest) to investigate the incidence of RBD. The PD patients were then divided into the RBD group and non RBD group, according to their answers to the NMSquest. Then the clinical differences were investigated between PD patients with and without RBD on the aspects of demographic characters, Hoehn-Yahr (H-Y) stage, the scores of Unified Parkinson Disease Rating Scale (UPDRS) sub-items, the incidence of non motor symptoms, and the dysfunctions of non motor systems (cognitive impairment, anxiety, depression and sleep disorders ). The evaluation tools of non motor functions include Mini Mental State Exam ( MMSE), Hamilton Depression Scale (HAMD), Parkins' s Disease Sleep Scale (PDSS) and Epworth Sleepiness Scale (ESS). Results ( 1 ) 62.9% (78/124) of the PD patients have been experiencing RBD. (2) The course of the disease in RBD group ( 3.8 ± 2.8 ) was significantly shorter than non RBD group (5.0 ± 2.5, t = - 1. 972, P = 0. 048 ) while the sex, age, onset age and the mode of onset, Levodopa dose equivalents (LDE) and the kinds of medicines showed no difference between the two groups. (3) H-Y stage, the scores of UPDRS sub-items and the incidence of motor complications showed no difference between RBD and non RBD group. (4) Most of the non motor symptoms, including the gastrointestinal dysfunctions, autonomic dysfunctions, mood disorders and sleep disturbances, occurred much frequently in RBD group, however, the scores of MMSE, HAMD, HAMA,PDSS and ESS showed no difference between the RBD and non RBD group. Conclusion RBD commonly occurred in PD patients, and PD patients with RBD have a tendency to suffer from dysfunction of non motor systems.

Objective To derive a questionnaire to assess the risk of developing motor complications through a 3-year prospective investigation on 71 patients of Parkinson' s disease (PD) in the out clinic at our hospital.Methods Three years after the first assessment,71 PD out patients were reassessed using various scales,including Unified Parkinson Disease Rating Scale,Hoehn-Yahr grade,Mini Mental State Exam,Hamilton Depression Scale and Hamilton Anxiety Scale.Results The incidence of motor complications was 43.6％ (31/71).Logistic regression analysis showed that the prognostic factors for motor fluctuation were age of onset ≤ 54 (OR =6.4,95％ CI 1.7-24.5,P =0.006),the occurrence of swallowing difficulty (OR =3.8,95 ％ CI 1.0-14.1,P =0.04) and depression (OR =4.0,95 ％ CI 1.1-13.7,P =0.03),and the prognostic factors for dyskinesia were age of onset ≤54 (OR =48.5,95％ CI 1.9-121.0,P:0.02),the occurrence of falling (OR =64.1,95％ CI 2.9-142.2,P =0.008) and the daily levodopa dosage ＞ 600 mg(OR =17.5,95％ CI 1.1-276.2,P =0.04).Based on the regression model,the assessment questionnaire for motor complicationsincludes the followings:the questionnaire for motor fluctuations:the age of onset ≤54,2 points; the occurrence of swallowing difficulty,1 point; the occurrence of depression,1 point; the questionnaire for dyskinesia:the onset age ≤54,2 points; the occurrence of falling,3 points; daily levodopa dosage ＞ 600 mg,2 points.In all patients in this study,21.7％ (10/46) was asscssed to a total scorc of 0-1 which is associated with a low risk of motor fluctuation,8/16 had a score of 2 which is associated with intermediate risk and 8/9 got a score of 3-4 associated high risk; 10.2％ (5/49) had a score of 0-2,a low risk of dyskinesia,4/13 had a score of 3-4,a intermediate risk and 7/9 got a score of 5-7 which is associated with a high risk.Conclusions Age onset ≤54,the occurrence of swallowing difficulty,falling and depression,daily levodopa dosage ＞ 600 mg were considered to be the prognostic factors of motor complications in PD.The questionnaire may help to stratify PD patients into low-risk,medium-risk and high-risk groups for motor complications and the higher the score in the questionnaire is related to the higher risk of motor complications.

Objective To assess the development,progression and change of nonmotor symptoms in patients with Parkinson' s disease and its impact on patients' quality of life.Methods Eighty-seven consecutive patients with idiopathic Parkinson' s disease were studied.Parkinsonian status was assessed at baseline and 3 years follow-up using Unified Parkinson' s Disease Rating Scale (UPDRS) part Ⅲ & Ⅳ,Nonmotor Symptoms Questionnaire (NMSQuset),Parkinson-related quality of life (PDQ) scales.Paired ttest,Chi-square test,Spearman rank order correlation and hierarchical regression of the major statistical procedures were employed.Results At 3 years follow-up,compared to baseline,the UPDRS Ⅲ score (22.21 ±11.31 vs 30.49± 11.68),UPDRS Ⅳ score(1.00±1.54 vs 2.94±3.12),NMS score (7.98±3.96 vs 12.35 ± 5.12) and PDQ score (28.11 ± 22.88 vs 36.65 ± 26.95) were significantly higher ( t =- 5.54,- 5.75,- 6.46,- 5.29,all P =0.000,respectively).The aggravation of motor and nonmotor symptoms caused the decline of quality of life.The prevalence of constipation,problem of remembenng thing,nocturia ranked tops,and depression,and anxiety were still in the middle,compared with baseline.The prevalence of pains,sweating,dribbling,sense of incomplete emptying etc were significantly increased during the follow-up,△R2 were 21.6％ and 23.4％ respectively,resulting in the deterioration of quality of life.Conclusions PD nonmotor symptoms appear from the early stage.The motor and nonmotor symptoms aggravate over time.

Objective To observe progression of motor symptoms and occurrence of motor complications in parkinsonian patients and investigate the rate of progression of motor symptoms and risk factors of motor complications.Methods One hundred and thirty patients diagnosed with PD in 2007 in Department of Neurology,Xinhua Hospital were followed up for 3 years.The Unified Parkinson' s Disease Rating Scale (UPDRS) and H-Y staging were used to assess and follow up motor symptoms and occurrence of motor complications,and analyze the rate of progression of motor symptoms and risk factors of motor complications with statistics.Results ( 1 ) Mean annual growth in H-Y staging was 2.5％,and UPDRS motor scores was 3.1％ ; the incidence of dysphagia at endpoint in patients was increased by 23.0％ compared with baseline; incidence of falls was increased by 16.7％;(2)Daily levodopa dose at endpoint ( OR =1.004,95％ CI 1.001—1.006,P =0.008 ) was independent risk factors with dyskinesia; While duration ( OR =1.637,95％ CI 1.083—2.473,P =0.019 ),levodopa treatment duration ( OR =0.698,95％ CI 0.494—0.987,P =0.042 ),daily levodopa dose at haseline ( OR =1.005,95％ CI 1.001—1.010,P =0.016) and at endpoint ( OR =1.014,95 ％ CI 1.001 —1.027,P =0.032 ) were risk factors with motor fluctuations.Conclusions As the disease progresses,motor function in parkinsonian patients gradually worsens,the incidence of swallowing difficulty and of falls is increased,and the incidence of motor complications is increased.The total exposure to levodopa in parkinsonian patients is predictor for motor complications.

Objective To evaluate the olfactory function and its influence factors by using Sniffin ’ Sticks test, and to compare the quality of Parkinson ’s disease (PD) recognition between Sniffin’ Sticks and 16 kinds of odor identification in Sniffin ’ Sticks(SS-16) tests.Methods The Sniffin’Sticks test was used to assess the olfactory function of 68 PD patients and 76 healthy volunteers , and the relationship between smell and age, disease duration, Unified Parkinson’ s Disease Rating Scale score, Hoehn-Yahr (H-Y) rating, and cognitive function level (Montreal Cognitive Assessment) was analyzed.Results (1)The prevalence of olfactory dysfunction in PD group (83.3%) was significantly higher than that in control group (21.2%).The Sniffin’ Sticks test showed that the odor threshold score (6.6 ±3.2, P=0.000), odor discrimination score (6.6 ±3.3, P=0.000), 16 kinds of odor identification score (6.8 ±2.4, P=0.000) in PD group were significantly lower than those in control group.( 2 ) When comparing the PD cases and healthy controls in recognition , the sensitivity and the specificity of the Sniffin ’ Sticks test were 0.897 and 0.737, respectively, similar to the SS-16 test.However, the Sniffin’ Sticks test showed advantage compared with odor threshold and odor discrimination.( 3 ) The olfactory score in PD group was positively correlated with cognitive function (r=0.243, P=0.046), and was unrelated with age, gender, disease duration, and disease severity.The olfactory score in control group was negatively correlated with age (r=-0.270, P=0.018), but positively correlated with cognitive function (r=0.281, P=0.014).Conclusions There is a higher incidence of olfactory dysfunction in PD patients than in control group.Sniffin’ Sticks test is superior to SS-16 test in quantitative and qualitative analysis of olfactory function in PD patients.Two tests both have high sensitivity and specificity in the recognition of PD .

Objective To investigate the recognition status and attitudes of general practice medical professional for rural-oriented clinical medical (general practice direction) students, and provide effective basis for teaching reform. Methods Using cluster sampling method, a questionnaire survey was conducted among 305 rural-oriented medical students in Hubei Medical University who belonged to four different grades. The questionnaire effective recovery was 98.07%, SPSS 17.0 software was used to analyze data, pro-portion (%) were used for statistical descriptive, chi-square test and nonparametric test were used for statis-tical inference. Results 16% (49) students believed that it was not necessary for local medical colleges and universities to set up general practice professional, The rates of students who understood this professional training objectives, employment channel, the future work and professional developments were 82.3% (251 students ), 64.5% (197 students ), 69.2% (211 students) and 66.9% (204 students ), respectively. 27.5%(84) of the students still didn't understand this professional curriculum, and lower cognitive learning public health curriculum. Only 31.1%(105) of students were satisfied with the current general medicine education.52.5% (160) students thought that the professional curriculum system had problems, mainly for the course content overlap and course setting time being not reasonable. Different grades of students had different de-gree of satisfaction in the professional knowledge, the general practice of professional learning attitude, teaching arrangement . Conclusion We should strengthen rural-oriented medical students' ! professional education thought and their cognition of general medicine as soon as possible and integrate and optimize the curriculum system, adjust the teaching content and set up reasonable curriculum opening time.

OBJECTIVETo investigate the effects of chronic amiodarone therapy on L-type calcium current recovery and action potential duration of rabbit ventricular myocytes.

METHODSHealthy rabbits (1.6-1.8 kg) were treated with amiodarone (80 mg x kg(-1) x d(-1)) for four weeks. Action potential duration (APD) was recorded under isolated arterially perfused left ventricular wedge preparation, then single myocytes were isolated using enzyme digestion. L-type calcium current recovery (time constant, tau) were determined by fitting data with monoexponential. Tau/APD90 were compared in cells treated with saline, amiodarone and sotalol (3 x 10(-5) mmol/L).

RESULTSIn chronic amiodarone treated myocytes, tau [(164 +/- 8) ms vs. (98 +/- 8) ms, P<0.05], APD90 [(321 +/- 12) ms vs. (220 +/- 10) ms, P<0.05] and tau/APD90 (0.51 +/- 0.03 vs. 0.44 +/- 0.03, P<0.05) were significantly increased than those in control myocytes. Sotalol significantly increased tau [(128 +/- 7) ms vs. (98 +/- 8) ms, P<0.05] and ADP90 [(405 +/- 13) ms vs. (220 +/- 10) ms, P<0.05] while reduced the tau/APD90 (0.32 +/- 0.05 vs. 0.44 +/- 0.03, P<0.05) compared to control myocytes.

CONCLUSIONThe differential effect of amiodarone and sotalol on ventricular myocytes tau/APD90 ratio might be responsible for the safety profile of these two drugs.

Action Potentials ; Amiodarone ; pharmacology ; Animals ; Anti-Arrhythmia Agents ; pharmacology ; Calcium Channels, L-Type ; drug effects ; physiology ; Myocytes, Cardiac ; drug effects ; physiology ; Patch-Clamp Techniques ; Rabbits ; Sotalol ; pharmacology

OBJECTIVETo study the role and possible mechanisms of gap junctional intercellular communication (GJIC) involved in mesangial cell (MC) proliferation which could be inhibited by bufalin.

METHODSRat mesangial cells were cultured in vitro. The effect of bufalin on platelet-derived growth factor-BB (PDGF-BB)-induced MC proliferation was evaluated by MTT assay. The function of GJIC was detected by Lucifer Yellow scrape loading and dye transfer (SLDT). mRNA levels of Cx43, Cx45 and Cx40 were measured by RT-PCR. Intracellular calcium concentrations ([Ca(2+)]i) were examined in laser scanning confocal microscopy after loading by Fura-3/AM.

RESULTSMTT indicated that bufalin could inhibited PDGF-BB-induced MC proliferation (P<0.01). Compared with the hormal control group, PDGF-BB inhibited GJIC function, increased the expression of Cx45 and Cx40 (P<0.01) without altering the Cx43 (P>0.05) in gene level and also increased [Ca(2+)]i. However, bufalin treatment enhanced GJIC function, decreased Cx45 mRNA and Cx40 mRNA expression (P<0.01), and reduced [Ca(2+)]i (P<0.01).

CONCLUSIONSBufalin inhibits PDGF-BB-induced MC proliferation, and its possible mechanisms may be related to regulation of Cx45 and Cx40 expression in the gene level, reduction of [Ca(2+)]i and enhancement of GJIC function.

Animals ; Bufanolides ; pharmacology ; Calcium ; metabolism ; Cell Communication ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Gap Junctions ; drug effects ; Mesangial Cells ; drug effects ; physiology ; ultrastructure ; Proto-Oncogene Proteins c-sis ; pharmacology ; Rats

OBJECTIVETo investigate the dynamics and clinical significance of serum hepatitis B virus (HBV) DNA levels during the terminal phase of acute-on-chronic liver failure (ACLF) with different hepatitis B e antigen (HBeAg) status.

METHODSOne-hundred-and-seven patients with terminal ACLF were tested for HBeAg status by electrochemiluminescence immunoassay and serum HBV DNA levels by real-time PCR at three chronological time ranges, representing increasing severity of disease phases prior to death (day 0): 29-56 d, 15-28 d, and 0-14 d.

RESULTSIn the 37 HBeAg(+) patients, HBV DNA levels at above-mentioned phases were 6.10+/-1.63, 5.61+/-1.50, and 5.29+/-1.96 log10 copies/mL. In the 70 anti-HBe(+) patients, HBV DNA levels were 4.63+/-1.82, 5.81+/-1.78, and 4.93+/-1.73 log10 copies/mL. Phase to phase comparisons revealed that the HBV DNA level in the HBeAg(+) group was significantly higher than that in the anti-HBe(+) group at 29-56 d (P less than 0.05), and that 15-28 d and 0-14 d were not significantly different (P more than 0.05). Intragroup comparisons of phases revealed no significant differences in the HBeAg(+) group (P more than 0.05), but a significant difference between 15-28 d and 0-14 d (P less than 0.05) for the anti-HBe(+) group.

CONCLUSIONSerum levels of HBV DNA in patients with HBeAg positivity are higher than those in patients with anti-HBe positivity as the disease phase of ACLF nears fatality. Following the deterioration to liver failure, the HBV DNA load in HBeAg(+) patients remains stable while that in anti-HBe(+) patients decreases.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; DNA, Viral ; blood ; End Stage Liver Disease ; blood ; virology ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; blood ; pathology ; Humans ; Liver Failure, Acute ; blood ; virology ; Male ; Middle Aged ; Viral Load ; Young Adult