Parkinson's disease (PD) is a common neurodegenerative disorder with typical motor symptoms and a variety of non-motor symptoms,including neuropsychiatric symptoms,autonomic dysfunctions,abnormal sense,sleep disorders and fatigue.Studies showed that several non-motor symptoms,such as olfactory dysfunction,constipation,rapid eye movement sleep behavior disorder,depression and fatigue,can occur before the onset of motor symptoms.Fatigue has been considered as one of the most disabling symptoms,and it has a significant impact on activity of daily living and quality of life,and brings heavy burdens to caregivers.However,fatigue in PD has no special biomarkers,so clinicians are lack of the recognition and intervention.Here,we will expound the prevalence,risk factors,rating scales and potential mechanism relating to neuropathology,neuroinflammation and neurobiochemistry in PD patients with fatigue.

Objective To investigate if the endothelin-1 (ET-1),nitric oxide(NO) can affect renal artery blood flow and explore the clinical value of ultrasonography in hypertensive disorder complication pregnancy.Methods 18 patients of gestational hypertension,18 patients of gently preeclampsia,20 patients of severe preeclampsia and 20 normal pregnancy women were chosen in random.Color Doppler ultrasonography was used to detect the peak systolic velocity (PSV),end diastolic velocity (EDV),resistive index (RI),pulsatility index (PI) of renal interlobar artery.The levels of serum ET-1 and NO were measured by enzyme-linked immunosorbent assay (ELISA) and nitric acid recovery respectively.Results The level of EDV in preeclampsia patients were significant lower than the control group (P ＜0.05).The levels of RI,PI,S/D in preeclampsia patients were significant higher than the control group (P ＜0.05).The level of ET-1 in study group was higher than control group (P ＜0.01).The level of NO in study group was lower than control group (P ＜0.01).There was positive correlation between the RI,PI,S/D of renal interlobar artery and the level of serum ET-1.There was inverse correlation between the RI,PI,S/D of renal interlobar artery and the level of serum NO.Conclusions Endothelial dysfunction can cause unbalance of renal vessel systolic-diastolic function.The level of renal artery blood flow parameters can reflect the state of vessel function and have clinical value in hypertensive disorder complication pregnancy.

Objective To investigate the effects of tumor necrosis factor-α ( TNF-α ) on the resensitization of human lung cancer cell lines A549/DDP to cisplatin (DDP) and to explore the relationship between the expression of TNF-αand resistance-related protein (LRP) in lung tissue.Methods The cytotoxic effects of combinational treatment by TNF-α and cisplatin on A549/DDP were measured by MTT assay.The expression of LRP was assessed by immunocytochemistry methods.Results The IC50 of A549/DDP to cisplatin were decreased from 7.12 ng/L to 5.02 ng/L,4.41 ng/L respectively by 250 U/ml and 1000 U/ml TNF-α treatment ( P ＜ 0.01 ),with the sensitivity of A549/DDP to cisplatin increased by 1.42 and 1.62 fold respectively.LRP was overexpressed in A549/DDP cell.250 U/ml or 1000 U/ml TNF-α plus cisplatin treatment down-regulated the expression of LRP with the positive rates of ( 60.14 ± 6.54 ) ％ and ( 57.23 ± 5.98 ) ％respectively,which were significantly lower than that of cisplatin alone treatment ( 75.97 ± 5.32 ) ％ and control group (79.63 ± 4.78 ) ％ ( both P ＜ 0.01 ).Conclusion Tumor necrosis factor-α can reverse the resistance of A549/DDP to cisplatin,which may be partially attributed to down-regulating LRP expression.

Objective To construct pcDNA 3.1(+)/HPV 18 E 6 fusion gene and a single-codon mutation pcDNA 3.1(+)/E6 F49R or pcDNA 3.1(+)/E6 F127R fusion gene in eukaryotic expression vector and study the effects on proliferation and apoptosis of cervical carcinoma cell line Hela. Method HPV 18 E6 gene sequence and the single-point mutation HPV 18 E6 F49R or HPV 18 E6 F127R were amplified from total RNA of Hela cell line by reverse transcription- polymerase chain reaction ( RT- PCR), then the gene sequences were respectively inserted into pcDNA 3.1(+) vector to reconstruct recombinant plasmids which were transfected transiently into Hela cells. MTT and RT-PCR were used to test the expression levels of HPV 18 E6 and the growth of HeLa cells after transfected about 48 h. The proliferation and apoptosis of Hela cells were detected respectively by cell counting and AO/EB fluorescent vital staining. Results The pcDNA 3.1(+)/HPV 18 E6, pcDNA 3.1(+)/E6 F49R and pcDNA 3.1(+)/E6 F127R eukaryotic expression vectors were successfully constructed. The gene of HPV 18 E6 was discriminably detected in the HeLa cells which were transfected with the recombinant plasmids. After several days, the proliferation of Hela cells transfected with pcDNA 3.1(+)/E6 F49R or pcDNA 3.1(+)/E6 F127R plasmid were obviously inhibited and the apoptotic rates were significantly increased, then the proliferation of cells transfected with pcDNA(+)/HPV 18 E6 was rather increased slightly, and we could observe the phenomena of early apoptosis and the formation of thekaryopyknosis by fluorescent microscope in the cells transfected with pcDNA 3.1(+)/E6 F49R or pcDNA 3.1(+)/E6 F127R. Conclusion The eukaryotic expressing vectors encoding HPV 18 E6 F49R and HPV 18 E6 F127R provide fundamental basis for the further study on HPV 18 E6 mechanism as well as prevention and treatment of uterine cancer.

Objective:In this study,we examined the HLA-DPB1 alleles in patients with tuberculosis,and health individuals attempt to investigate the association between the polymorphism of HLA-DPB1 gene and pulmonary tuberculosis in Han population in Shihezi area in Xinjiang uygur autonomous region of China.Methods:High-resolution typing of DPB1 was performed by the sequence-based typing ( SBT) method using the SBT-HLA-DPB1 generic DNA typing kit.Results:In the controls ,17 HLA-DPB1 alleles were ob-served,the HLA DPB1*0501 (28.1%) and HLA DPB1*0201(27.6%) frequency was significantly higher than other sites ,the first and second respectively.The frequency of HLA-DPB1* 0201 was observed significantly increased in patient group compared with control group ( P<0.05 );the frequency of HLA-DPB1* 0501 was observed significantly decreased in patient group compared with control group ( P<0.05 ).Conclusion: The gene frequencies of HLA-DPB1 in Xinjiang Shihezi Han population are roughly in consistence with other northern Chinese Han population;the HLA-DPB1*0201 may be the protective factor to pulmonary tuberculosis , and HLA-DPB1*0501 may be susceptible to pulmonary tuberculosis in Han population from the Xinjiang uygur autonomous region of China.

Objective To assess the value of confocal laser endomieroscopy (CLE) in diagnosis of early esophageal squamous cell carcinoma and precancerous lesions. Methods CLE examination was performed in 41 patients who needed further examination because of lesions in esophagus during July 2008 to April 2009. The diagnosis was made based on the features of esophageal squamous cells which was defined as low grade intraepithelial neoplasia(LGIN), high grade intraepithelial neoplasia (HGIN) and early esophageal squamous cell carcinoma (EC). Biopsy specimens were taken precisely matched to the CLE imaging sites. The result was compared with that of histopathology. Results There were 7281 eonfocal images obtained from 60 target lesions in 41 patients. The sensitivity, specificity and accuracy of CLE were 75.0%, 88.6% and 85.0% in diagnosis of LGIN, respectively, 85.7% ,92.3% and 90.0% in diagnosis of HGIN, respectively,and 88.9% ,96.1% and 95.0%, in diagnosis of EC,respectively. Conclusions It is an effective method for diagnosis of esophageal neoplastic lesions using CLE, which has high accuracy in diagnosis of HGIN and early esophageal cancer.

objective To analyze the clinicopathological features and prognosis of antiglomerular basement membrane(GBM)disease,and evaluate the efficacy and safety of double filtration plasmapheresis(DFPP). Methods A total of 35 hospitalized patients diagnosed as anti-GBM disease in our department were enrolled in the study.All the patients were divided into 3 groups according to the manifestations at admission.Group Ⅰ∶24 patients with severe pulmonary hemorrhage or rapidly progressive glomerulonephritis(RPGN)received pulse methylprednisolone with or without DFPP,and then followed by prednisone and CTX.Group Ⅱ∶5 patients without severe pulmonary hemorrhage and RPGN received prednisone and CTX.Group Ⅲ∶5 ESRD patients and 1 normal renal function patient did not receive immunosuppression therapy.Anti-GBM antibody titer of pre-and post-DFPP in 4 patients was measured consecutively,and removal rate was calculated.Results The mean age of all the patients was(41.1±16.6)years.Sixteen patients(45.7%)presented Goodpasture's syndrome.Eighteen patients(51.4%)had anti-GBM glomerulonephritis alone,whereas one suffered solely from pulmonary hemorrhage.20%patients had positive P-ANCA serology.54.2%crescentic glomerulonephritis and 7 with other glomerulonephritis were revealed by kidney biopsy in 24 patients.Patients in Group Ⅰ showed more severe manifestation at admission:higher Scr level,higher titer of anit-GBM antibody,greater percentage of crescents.Within the follow-up period,7 patients died and kidneys of 50%patients survived.No patient died in Group Ⅱ and Ⅲ.The elder age,anemia,higher Scr(＞300 μmol/L),oliguria or anuria,emergency hemodialysis at admission,and more glomerular sclerosis were predictors of poor prognosis.The anti-GBM antibody was negative after 4 to 6 sessions of DFPP.and the mean removal rate was 55%.During total 94 DFPP sessions,there was no unacceptable morbidity. Conclusions Different therapy strategy is necessary for anti-GBM disease with different clinical manifestations.DFPP is an effective and safe clearance way of anti-GBM antibody.

Objective To investigate the relationship between serum neutrophil elastase(NE),Sortilin and carotid atherosclerotic(CAS)plaque in patients with acute cerebral infarction(ACI)and its predictive value for poor prognosis.Methods A total of 155 patients with ACI admitted to Daxing Teaching Hospital of Cap-ital Medical University from December 2020 to November 2022 were selected as the study objects.According to carotid intima-media thickness(IMT),they were divided into normal IMT group,thickened group and plaque group,and 40 healthy subjects were selected as control group during the same period.The serum levels of NE and Sortilin in all groups were compared and their correlations with IMT were analyzed.ACI patients were followed up for 3 months and divided into good prognosis group and poor prognosis group.Serum NE and Sortilin levels were compared between the two groups.Multivariate Logistic regression was used to ana-lyze the risk factors of poor prognosis in ACI patients.Receiver operating characteristic(ROC)curve was used to predict prognosis.Results The levels of serum NE and Sortilin in control group,IMT normal group,thick-ened group and plaque group were increased successively(P<0.05).Pearson correlation analysis showed that serum NE and Sortilin levels were positively correlated with IMT(r=0.509,0.483,P<0.05).The incidence of poor prognosis in ACI patients was 39.35%.The proportion of diabetes mellitus,age,admission National Institutes of Health Stroke Scale(NIHSS)score,low density lipoprotein cholesterol,total cholesterol,fasting blood glucose,white blood cell count,serum creatinine,NE,uric acid(UA)and Sortilin levels in poor progno-sis group were higher than those in good prognosis group(P<0.05).Multivariate Logistic regression analysis showed that admission NIHSS score and UA,NE and Sortilin levels were independent risk factors for poor prognosis in ACI patients(P<0.05).ROC curve analysis showed that the area under the curve of serum NE,Sortilin and UA alone and combined to predict poor prognosis were 0.695,0.740,0.752 and 0.869,respective-ly.The combined prediction efficiency of serum NE,Sortilin and UA was higher than that of single detection of each indicator.Conclusion The increase of serum NE and Sortilin levels in ACI patients is positively corre-lated with CAS,and is an independent risk factor for poor prognosis in ACI patients.Detection of serum NE and Sortilin levels could help predict the short-term prognosis of ACI patients.

INTRODUCTIONMinimally invasive surgery (MIS) is increasingly used in the treatment of lumbar stenosis. However, it is still not clear if the employment of minimally invasive surgical techniques can achieve superior clinical outcomes compared to standard open laminectomy.

MATERIALS AND METHODSAn extensive literature review regarding the clinical outcome, safety, and efficiency of MIS and standard open surgery (OS) in the treatment of lumbar stenosis was conducted on Medline, Cochrane, EMBASE, and Google Scholar databases up to 19 August 2016.

RESULTSSixteen studies that enrolled a total of 1580 patients with surgically-indicated lumbar stenosis were identified; 793 patients underwent MIS and 787 patients underwent conventional OS. No significant difference was found in the improvement of Oswestry Disability Index (ODI) (P = 0.718) and operation time (P = 0.322) between patients from different treatment groups. MIS was associated with better visual analogue scale (VAS) for back pain (P = 0.01), shorter length of hospital stay (P <0.001), and lower blood loss (P <0.001).

CONCLUSIONOur findings indicate that both MIS and standard OS can effectively manage patients with lumbar stenosis and lead to comparable clinical outcomes. Further studies are necessary to evaluate MIS with different types of conventional surgery for lumbar stenosis.

Objective To explore the safety and efficacy of intrathecal administration of adipose stem cells de-rived from bioactive secretome (ASCBS)in treatment of whiter matter injury (WMI)in the preterm infants. Methods Sixty - three cases of WMI were recruited according to the uniform standards from multiple medical centers and they were divided into 3 gestational age (GA)subgroups,which were 21 cases in group A (GA 24 - 28 + 6 ),20 cases in group B (GA 29 - 32 + 6 ),and 22 cases in group C (GA 33 - 36 + 6 ). The patients were randomly divided into treatment groups and control groups by tossing coins. The treatment groups received lumbar puncture followed with ASCBS intra-thecal injection once daily for 3 consecutive days. Follow - up study included Neonatal Behavioral Neurological Assess-ment (NBNA)at term - equivalent age and neurodevelopment at corrected age of 6 - month. Neurodevelopment was assessed by using the Bayley Scales of Infant Development and Peabody Developmental Motor Scale. The survival rates, NBNA scores,mental development index (MDI),psychomotor develop index (PDI),total motor development quotient, gross motor development quotient and fine motor development among each subgroup were compared. Results Sixty -three cases were recruited,including 31 in the treatment group and 32 in the control group. Only 1 case in the treatment groups lost in the follow - up. No clinical side effects were found in the treatment groups. There was no significant diffe-rence in the survival rate and complication in the preterms in all subgroups of the treatment group and control group (all P > 0. 05). The gross and total motor development quotient in the treatment group A was higher than that in the control group A(gross motor development quotient:98. 330 ± 6. 282 in treatment group A,90. 330 ± 3. 777 in control group A, P = 0. 040;total motor development quotient:97. 330 ± 4. 803 in treatment group A,91. 000 ± 4. 472 in control group A,P = 0. 023). The rest findings showed no significant difference between groups. Conclusion The treatment of WMI in preterm infants with ASCBS is safe and can promote the motor development of preterm infants with GA in 24 - 28 weeks.