Objective To improve knowledge of the Wilson's disease by analysing its CT findings of the head.Methods CT scans were performed in all cases,CT findings of head were analysed retrospectively.Results CT findings were mainly brain atrophy and the low density of basal ganglia.31 cases had symmetrical ribbon-like or crescent low density in the lentiform nuclei,three had oval low density inthe caudate nucleus,four had symmetrical oval low density in the thalamus,one was normal but atrophy.All cases had brain atrophy.Conclusion The most common CT findings in hepatolenticular degeneration patients are mainly brain atrophy and low density of the basal ganglia,especially the symmetrical low density of the lentiform nuclei is characteristic of Wilson disease on CT.

Objective To investigate the alteration of phosphorylated GluR1Ser831 and behavioural effects in a rat model of levodopa-induced motor complications after Ca2 +/calmodulin-dependent protein kinase Ⅱ (CaMKⅡ) inhibitor KN-93 treatment. Methods The hemi-parkinsonian rat model was produced by injecting stereotaxically 6-OHDA to right medial forebrain bundle. Then, rats were intraperitoneally treated with levodopa ( 50 mg/kg with benserazide 12.5 mg/kg,twice daily) for 22 days. On day 23 ,rats received KN-93 before levodopa administration. Rotational duration was estimated. After sacrificed, subcellualr distribution of GluR1 and phosphorylated GluR1Ser831 were observed by western blot. Results The study showed that CaMKⅡ inhibitor KN-93 prolonged rotational duration. Moreover, KN-93 could regulate subcellular distribution of GluR1 and reduce hyperphosphorylation of GluR1 Ser831, which was closely associated with levodopa-induced motor complications. The expression of membrane GluR1 and phosphorylated GluR1Ser831 was (83.4 ±4.2)% and (47.2 ±5.2)% ,respectively. Conclusions These results indicated that activation of CaMKⅡ contributed to development of motor complications, through a mechanism that involved an increase in phosphorylated GluR1 Ser831. Pharmaceuticals which act to inhibit CaMKⅡ may be useful in the treatment of the motor complications in parkinsonian patients.

Objective To examine the caregivers' burden and quality of life (QOL) of main caregivers of patients with Parkinson's disease by analyzing caregiver and patient-related factors. Methods A total of 53 cases with Parkinson's disease seen from October 2012 to December 2013 in Yantaishan hospital of Yantai City were selected. Assessments: (a) EuroQol-5 questionnaires, including: EQ-5 dimensions (EQ -5d) and visual analogue scale (VAS). (b) Unified Parkinson's Disease Rating Scale. (c) Hoehn-Yahr(H-Y) stage; (d) Parkinson's disease sleep scale (PDSS), 15 items; (e) Hamilton Anxiety Rating Scale (HAMD-14), Hamilton Depression Rating Scale (HAMA-24); (f) Chinese version of Zarit caregiver burden interview. Results Spearman correlation analysis showed that the EQ-5D index and EQ-VAS negatively correlated with HAMD-14 of caregivers of Parkinson diseasepatients (r=- 0.318, - 0.046) (P<0.05), and negatively correlated with H-Y staging (r=-0.592, -0.531), UPDRSI (r=-0.434, -0.316) , UPDRS Ⅱ (r=0.521, 0.513) , UPDRS Ⅲ (r=0.520, 0.534), UPDRS Ⅳ (r=0.564, 0.509), PDSS in patients with Parkinson's disease (r=0.547, 0.490), HAMD-14 (r=0.315, 0.350), HAMA-24 (r=0.413, 0.401) of Parkinson's disease patients (P<0.05). Caregiver burden was related with HAMD-14 (r=0.496), HAMA-24 (r=0.551),H-Y stage (r=0.697), PDSS (r=0.659), UPDRS Ⅰ-Ⅳ (r=0.538, 0.668, 0.696, 0.600), EQ-5D index of Parkinson disease patients (r=0.682), EQ-VAS of Parkinson disease patients (r=0.670) (P<0.05); and positively related with anxiety of caregivers (r=0.275) , and a negative correlation with the caregivers' quality of lives (r=0.665) (P<0.05). Bivariate analyses showed significant correlations between caregiver burden and patients' sleep, scores of Parkinson's motor symptoms, and caregivers' depression. Based on multiple regression analysis, Zarit score proved to be the main predictor of caregivers' QOL. Caregivers' age, total numbers of caregivers and H-Y stage also proved to be a relevant factor. Conclusion Improvement of patient's sleep, motor symptoms anddepression might alleviate caregivers' strain. There is a correlation between caregivers' burden and QOL. QOL of caregivers can be improved through reducing their care-burden.

Objective To study the value of helical multi-phase contrast scanning in the preoperative evaluation of cholangiocarcinoma hilar.Methods Pre-and post-contrast CT scanning of upper abdomen were performed in 26 cases with hepatic portal cholangiocarcinoma.Arterial phase scan of the whole liver began at 30 s after initial injection of contrast medium and the portal venous phase scan started at 70 s.15 of 26 cases underwent additional delayed phase scans began at 3~4 min.Thin thickness(3~5 mm)scanning of hepatic portal was used in each post-contrast phase scanning.The location,size,enhancement patterns of the lesions and the extent of the tumor involvement were observed and surgical resecetability was evaluated.Results All of 26 lesions were detected in helical multi-phase contrast scanning. 16 lesions enhanced on the arterial phase. On the portal venous phase, all lesions were enhanced and marked enhancement was seen in 19 lesions. Prolonged enhancement was seen in 15 lesions on the delayed phase scanning. The accuracy of evaluating surgical respectability was 84.62%. Conclusion Multi-phase contrast scanning combined with thin thickness scanning can demonstrate obviously the location and enhanced patterns of hepatic portal cholangiocarcinoma, the accuracy in evaluating surgical respectability is improved, and it is helpful in choosing the preoperative treatment program and assessing the prognosis.

Objective To explore the diagnostic value of 64-slice spiral CT on atlas vertebral artery sulcus ring syndrome.Methods The 48 atlas vertebral artery sulcus ring patients who were found by conventional anterior posterior and lateral X-ray film were collected.The 64-slice spiral CT volume scan and following volume restitution(V R)and multiplanar reconstruction(MPR)were underwent,and multi-directional structural morphology was displayed.Their relationship with clinical features were analyzed.Results Among 48 cases of atlas vertebral artery sulcus ring,24 cases were shown with right complete bridge[pore size(6.59±0.50)mm],36 cases with left complete bridge[pore size(6.19±0.49)mm],24 cases with right incomplete bridge and 12 cases with left incomplete bridge.Thirty cases were diagnosed as atlas vertebral artery sulcus ring syndrome,and all had the atlantoaxial joint asymmetry and vertigo of different degree when head and neck rotated.Conclusions The 64-slice spiral CT can clearly display the anatomical features of posterior bridge of atlas and measure the pore size of atlas vertebral artery sulcus ring,and it has important diagnostic value for atlas vertebral artery sulcus ring syndrome.

Objective To study the supporting role of traditional Chinese medicine GanFuAn in the treatment of high-risk state of liver cancer by color Doppler ultrasound.Methods Based on a number of joint detection of tumor markers,85 patients of liver cancer were selected from patients with chronic hepatitis B.Among these 85patients,50 patients were selected in a treatment group and treated with Chinese herbal preparation GanFuAn,with ultrasound and tumor markers serving as joint monitoring; while the other 35 patients were selected in a control group and treated with conventional treatment.Results In the treatment group,the liver tumor markers or liver tumor continually diminished.5 cases showed tumor disappear.38 cases showed effective results,while 7 cases showed no effects.The total incidence rate of liver cancer was 14％;while in the control group,none case showed tumor disappear.20 cases showed effects and 15 cases showed none effects.The cumulative incidence rate of liver cancer induced by chronic hepatitis was 43％,with all the cases have been confirmed by pathology.Conclusion Color doppler ultrasound was an intuitive,non-invasive dynamic method to monitor liver tumor's growth and decline.

Objective To review the status of diagnosis and treatment for invasive fungal pulmonary infections(IFPI)in Lishui Central Hospital.Methods The clinical data of 79 patients with IFPI were retrospectively analyzed.Results The diagnostic status could be classified ills follows:6 eases had confirmed diagnosis,30 had clinical diagnosis,35 had suspected diagnosis and 8 misdiagnosed.The treatments were all effeetive in 6 COnfirmed cases;in 30 clinically diagnosed cases,6 were eriective.21 were inefiective and 3 died;in 35 suspected cases.3 were effective.25 were iHefieetive and 7 cflses did not receive antifungal treatment.Aspergillus and Cryptococcus pulmonary infections were predominant in confirmed cases.and the antifungal treatment lasted for 3 to 6 months.Conclusion Diagnosis and treatment for IFPI need to be improved.

BACKGROUND:Pathogenesis of Parkinson’s disease is not completely understood, and there is yet no effective therapy that can prevent the neurodegenerative process of the disease fundamentaly. OBJECTIVE:To explore the effects of pituitary adenylate cyclase-activating polypeptide (PACAP) on lactacystin-induced Parkinson’s disease dopaminergic PC12 cel apoptosis and its molecular mechanism. METHODS: Under induction by nerve growth factors, PC12 cels differentiated into dopaminergic neurons, and then were treated with different concentrations of lactacystin for different time. When the cel survival rate was about 50%,the concentration and action time oflactacystin were selected to establish cel models of Parkinson’s disease. In the study, there were control group, lactacystin group, PACAP1-27 group (intervention group 1) and PACAP1-27+PACAP6-27 co-intervention group (intervention group 2). Changes of cel morphology were observed under inverted microscope; cel viability was detected with MTT method; the expression of endoplasmic reticulum stress specific protein caspase-12 was detected by western blot. Then the action of PACAP1-27 and PACAP6-27 to the cytoxicity of lactacystin was observed. RESULTS AND CONCLUSION: With different concentrations and action time of lactacystin, the viability of PC12 cels presented a concentration- and time-dependent decline. When the lactacystin at 20μmol/L acted for 24 hours, the cel viability was declined by about 50%. Under same conditions of lactacystin concentration and action time (20 μmol/L, 24 hours), the cels in the lactacystin group appeared to have damaged changes, declined cel viability, and increased caspase-12 activity in comparison with the control group (P< 0.01). Compared with the lactacystin group, the cel damage was relieved and cel viability was increased significantly in the intervention group 1 as wel as the expression of caspase-12 was decreased (P < 0.01). Experimental findings in the intervention group 2 were similar to those in the lactacystin group. These results suggest that lactacystin, an ubiquitin proteasome inhibitor, can lead to cel damage; PACAP1-27 plays a protective role by regulating the above-mentioned signal pathway. As one PACAP1-27 receptor antagonist, PACAP6-27 can attenuate this effect of PACAP1-27.

Objective:To investigate the changes in peripheral blood angiotensin-converting enzyme 2 (ACE2), high mobility group protein B1 (HMGB1) and interleukin 33 (IL-33) levels and their clinical significance in patients with primary lung cancer complicated by lung infection after surgery.Methods:The clinical data of 92 primary lung cancer patients treated at Longchang People′s Hospital from August 2018 to February 2021 were retrospectively collected, they were underwent radical lung cancer surgery, and were divided into the pulmonary infection group(27 cases) and the non-pulmonary infection group(65 cases) according to whether the patients had postoperative complications of pulmonary infection. The clinical data, peripheral blood ACE2, HMGB1 and IL-33 levels before and after surgery between the two groups were compared. The risk factors associated with postoperative pulmonary infection were analyzed by Lasso regression and Logistic regression. The predictive value of pulmonary infection was analyzed by receiver operating characteristic (ROC) curve. The cut-off values of peripheral blood ACE2, HMGB1 and IL-33 in the ROC curve were used as the boundary to divide the high level group and low level group, and the Kaplan-Meier survival curve was drawn to compare the survival rates of patients with high levels and low levels of peripheral blood ACE2, HMGB1 and IL-33.Results:The incidence of chronic obstructive pulmonary disease in the pulmonary infection group was higher than that in the non-pulmonary infection group: 40.74%(11/27) vs. 15.38%(10/65), there was statistical difference ( χ2 = 6.96, P<0.05). The levels of postoperative peripheral blood ACE2, HMGB1 and IL-33 in the pulmonary infection group were higher than those in the non-pulmonary infection group: (36.87 ± 9.87) mg/L vs. (25.94 ± 8.69) mg/L, (24.49 ± 8.14) μg/L vs. (16.74 ± 5.07) μg/L, (51.48 ± 8.25) ng/L vs. (39.88 ± 6.85) ng/L, there were statistical differences ( P<0.05). The results of Lasso regression and Logistic regression showed that the chronic obstructive pulmonary disease, postoperative peripheral blood ACE2, HMGB1 and IL-33 levels were independent risk factors for postoperative complications of pulmonary infection in patients with primary lung cancer ( P<0.05). The results of ROC curve showed that the area under the curve(AUC) values for postoperative peripheral blood ACE2, HMGB1 and IL-33 levels predicting postoperative complications of lung infection were 0.705, 0.821 and 0.768, respectively, and the AUC for the combination was 0.935. The risk of death in patients with high levels of postoperative peripheral blood ACE2, HMGB1 and IL-3 were 7.500, 4.874 and 2.857 times than the patients with low levels. Conclusions:Postoperative peripheral blood ACE2, HMGB1 and IL-3 levels in patients with primary lung cancer are important factors for pulmonary infection, which can be used for early prediction and evaluation after operation.

Objective To study the association between serum homocysteine (Hcy) level and cognitive impairment in PD patients.Methods Eighty-one PD patients admitted to our hospital were divided into normal cognition group (n=25),mild cognitive impairment group (n=32) and dementia group (n=24) with 19 healthy persons undergoing physical examination served as a control group.Their cognitive impairment was assessed according to their medical history,detailed physical examination data,Hoehn-Yahr scale score,MMSE score,and CDR score.Their serum levels of Hcy,folic acid and vitamin B12 were measured.The association of serum Hcy,folic acid and vitamin B12 levels with cognitive impairment was analyzed.Results The serum Hcy level was significantly higher in normal cognition group,mild cognitive impairment group and dementia group than in control group (P＜0.05,P＜0.01) and in dementia group than in normal cognition group (14.8±3.9 μmol/L vs 12.5±3.3 μmol/L,P＜0.05).The serum Hcy level was associated with oral levodopa and oral benserazide daily dose,oral levodopa and oral benserazide taking time,course of PD and age (r=0.298,P=0.000;r=0.280,P=0.000;r=0.301,P=0.000;r=0.184,P=0.019) but not associated with the severity of PD.Conclusion High serum Hcy level is one of the risk factors for cognitive impairment in PD patients,and control of oral levodopa dose contributes to the prevention and treatment of dementia in PD patients.