Objective Toevaluatethevalueofcombineddeterminationofvariousindicesintheclinicaldiagnosisofacutepancreatitis (AP)through dynamic measurements of the levels of peripheral serum C-reactive protein (CRP),lipase (LPS),interleukin-1β(IL-1β),andintercellularadhesionmolecule1(ICAM-1),aswellaschangesintheirlevels,inpatientswithAP.Methods Atotalof86 patients with AP who were treated in Fourth Affiliated Hospital of China Medical University from January 2010 to December 2012 were select-ed,among whom there were 39 patients with severe acute pancreatitis (SAP)and 47 patients with mild acute pancreatitis (MAP).Serum sam-ples were collected from these patients on days 1,3,5,and 7 of admission.Twelve healthy subjects were selected as controls.Enzyme-linked immunosorbent assay was applied to measure the levels of CRP,IL-1β,and ICAM-1 ,and the dry slides method was applied to measure the concentration of serum LPS.The t test and χ2 test were applied for comparison of continuous data and categorical data between groups, respectively.Results Onday1ofadmission,thepatientsinMAPgrouphadsignificantlyhigherlevelsofCRP,IL-1β,andLPSthan those in control group (t=-74.126,-60.135,and -364.153,respectively;all P<0.001);on day 1 of admission,the patients in SAP group had significantly higher levels of CRP,ICAM-1,IL-1β,and LPS than those in control group (t=-121.355,-25.728,-89.422,and -415.840,respectively;all P<0.001).The peak concentration of each index appeared on day 1 or 3 of admission,and decreased progressively in the course of therapy.The patients in SAP group had significantly higher levels of serum CRP,LPS,IL-1β,and ICAM-1thanthoseinMAPgroup(allP<0.05).Conclusion CombineddeterminationofserumCRP,LPS,IL-1β,andICAM-1 levels has a certain clinical value in early identification of severity of AP.

To explore the safety of ropinirole in the treatment of Parkinson′s disease( PD).A total of 221 PD patients participated in a multi-center,12-week randomized,bromocriptine-controlled,double-blind, double-dummy and parallel-group trial.The safety was assessed on the basis of adverse reactions , blood pressure,pulse,laboratory parameters and electrocardiography recordings.The incidence of adverse reaction was 34.9%in ropinirole group and 34.8% in bromocriptine group.And the frequency of adverse reactions had no inter-group statistical significance (χ2 =0.000,P=0.995).Ropinirole has an excellent profile of safety in the treatment of Chinese PD patients.

Objective To investigate changes in serum level of glial fibrillary acidic protein (GFAP) in patients with Parkinson disease (PD) and its clinical significance. Methods Serum GFAP was determined with sandwich ELISA for 82 patients with PD and acute cerebral infarction (ACI), as well as healthy normal controls. Patients with PD were then divided into two sub-groups in terms of their course duration, one with less than five years and the other with more than or equal to five years. Effects of course duration and age of the patients on their serum GFAP were analyzed. Results Serum level of GFAP was significantly higher in patients with PD [(1.628±0.104) μg/L] and ACI [(1. 637±0. 063 )μg/L] than that in healthy normal controls [ (0. 025±0. 003)μg/L, t = 82. 7, 142. 2, all P <0. 05 ]. But, there was no significant difference in serum GFAP between patients with PD and ACI ( t =0. 214, P > 0. 05 ). Serum level of GFAP in PD patients had no significant correlation with their age. There was no significant difference in serum GFAP between two sub-groups of patients with PD (P > 0.05 ). Conclusions Serum level of GFAP increased significantly in PD patients, as compared to healthy normal controls, but it is not specific. Serum GFAP in patients with PD maintained at certain high level with progression of the disease, indicating effect of astrocytes may persistently exist during the disease course.

Objective To investigate the expressions of serum cystatin C CysC),retinolbinding protein (RBP),serum and urinary β2-microglobulin (β2-MG) and their effects on predicting renal damage in primary hypertension in elderly patients.Methods A total of 149 patients were divided into 3 groups of hypertension grade 1 (n =50),hypertension grade 2 (n =50) and hypertension grade 3 group (n=49).92 healthy controls who took physical examination were selected as control group.The levels of serum CysC,RBP,serum and uric β2-MG,blood urea nitrogen,creatinine and other biochemical indexes were detected.The complications of hypertension were observed.The differences in renal function indexes between groups and their correlations were analyzed.Results There were 86 cases with hyperlipidemia (57.7％),71 cases with atherosclerosis (47.7％),59 cases with type 2 diabetes mellitus (39.6％),56 cases with coronary heart disease (37.6％),and 49 cases with cerebral vascular disease (32.9％) in 149 hypertensive patients.The levels of serum CysC,RBP,serum and uric β2-microglobulin were increased in hypertensive patients as compared with healthy controls (P＜0.05 or 0.01),and the extents of increments in the above indexes were positively correlated with blood pressure level [CysC:(1.2± 0.5) mg/L,(1.7±0.6) mg/L,(2.2±0.9) mg/L;RBP:(53.1±10.2) mg/L,(65.2±16.3)mg/L,(75.8±17.5) mg/L;serum β2-MG:(2.7±1.5) mg/L,(4.0±2.1) mg/L,(4.9±2.0) mg/L;uric β2-MG:(178.3±73.9) ng/L,(237.9±78.6) ng/L,(277.5±87.5) ng/L;respectively,P＜0.05or 0.01].Conclusions Elderly hypertensive patients are complicated with a variety of diseases.The levels of serum CysC,retinol-binding protein,serum and uric β2 microglobulin have significant diagnostic values on renal impairment caused by hypertension,and can be considered as sensitive factors for early renal impairment in essential hypertension.

One hundred patients with Parkinson's disease (PD) aged 60 and above treated with levodopa were enrolled in this cross section study.The general conditions,medication,unified Parkinson's disease rating scale (UPDRS) scores and the incidence of levodopa-induced dyskinesia (LID) were documented.The incidence rate of LID in this group of PD patients was 37.0％ (37/100).The incidence was significantly higher in patients with levodopa treatment ≥ 4 years than that in patients with levodopa treatment ＜ 4 years (55％ vs.26％,x2 =8.770,P =0.003).The incidence rate ofpeak dosage dyskinesia in tremor-dominant PD patients was lower than that in rigidity-dominant PD patients(x2 =4.399,P =0.036).The incidence rate of LID was correlated with the duration of levodopa therapy.Amantadine may reduce the incidence of off dystonia.

Objective To evaluate the effect of Parkinson's disease treatment guideline on the initial medicine therapy and to explore the impact of hospital grade level and type of insurance on the initial prescription for Parkinson's disease.Methods We identified 136 PD patients as part of a population-based study in Beijing and made a comparison between the patients with initial prescriptions of dopamine receptor agonists (DA) and levodopa (LD).Results Among 136 patients,excluding patients without initial medication of levodopa or dopamine receptor agonist,there were 61 cases with initial drug administration aged ≥ 65 years.Among the 61 cases,1 cases and 19 cases administrated dopamine receptor agonist and levodopa respectively before 2006,1 case and 11 cases respectively from 2007 to 2009,and 5 cases and 24 cases respectively after 2010.There was no significant difference in the percentage between patients with initial administration of levodopa and dopamine receptor agonist in the three periods (x2 =1.891,P =0.388).In 41 patients with initial drug administration of dopamine receptor agonist or levodopa aged＜65 years,1 cases and 23 cases administrated dopamine receptor agonist or levodopa respectively before 2006,0 case and 10 cases respectively from 2007 to 2009,and 3 cases and 4 cases respectively after 2010.There was significant differences in the percentage between patients with initial administration of levodopa and dopamine receptor agonist in the three periods (x2 =10.644,P=0.005).The percentage of patients with initial administration of dopamine receptor agonist aged＜65 years was increased after 2010 as compared before 2006 (x2 =7.219,P=0.028).There were no significant differences in the percentage of patients with initial administration of dopamine receptor agonist between grade 3 and non-grade 3 hospitals (13.6％ vs.6.3％,x2=0.675,P=0.686)and between patients with and without insurance (13.1％ vs.10.0％,x2=0.141,P=1.000).Conclusions The percentage of patients with initial administration of levodopa and dopamine receptor agonist has no significant difference between patients with initial drug administration aged ≥ 65 years before and after the introduction of Parkinson's disease treatment guideline,while the percentage is increased in patients with initial drug administration aged＜65 years.No impact of hospital grade level and type of insurance on initial administration for Parkinson's disease is found.

Objective To investigate the expression level of adenosine 2A receptors in peripheral blood lymphocytes and the correlation with disease progression of Parkinson's disease (PD).Methods In this retrospcctive study,out patients with PD(42 cases)and healthy controls(32 cases) were recruited at Beijing Hospital.The expression level of A2A receptors in peripheral blood lymphocytes was detected by flow cytometry.The concentration of free A2A receptors in plasma was detected by enzyme linked immunosorbent assay (ELISA).The expression of A2A receptors and plasma free A2A receptors in peripheral blood lymphocytes of the PD group and the control group was compared.Multivariate regression analysis and single factor correlation analysis were performed on sex,age,course of disease,duration of medication,drug type and dose,motor complications,and PD unified Parkinson's disease rating scale (UPDRS)score.Results A2A receptor expression in lymphocytes was significantly higher in the PD group than in the control group (8.96 ± 4.73)％ vs.(5.39±2.42)％ (t=4.210,P＜0.05).There was no significant difference in A2A receptor concentrations in plasma between the two groups (1.82 ± 1.91) μg/L vs.(1.15 ± 0.71) μg/L(t=1.078,P＞0.05).In the PD group,A2A receptor expression in lymphocytes in patients with motor complications was statistically lower than in patients without them (P＜ 0.05).Lymphocyte A2A receptor levels in the 5-9 years duration subgroup were significantly lower than those in the ＜5 years duration subgroup (Z=2.780,P＜0.01) and the≥10 years duration subgroup (Z=-2.149,P＜0.05).Conclusions The expression of A2A receptors in peripheral blood lymphocytes is correlated with PD.The expression of A2 A receptors in peripheral blood lymphocytes of patients with PD fluctuates with the occurrence of motor complications and the progression of disease.Further research is needed to establish A2A receptors as a biomarker for monitoring disease progression.

Purpose To investigate the expression of Beclin1, LC3 and mTOR in colorectal cancer ( CRC) and their significance. Methods Immunohistochemistry, Western blot and real-time PCR were employed to detect the expression of Beclin1, LC3 and mTOR in CRC. Results The positive expression rate of Beclin1, LC3 and mTOR in 242 cases of CRC was 90. 50%, 87. 19% and 46. 28%, respectively, which were higher than that in adjacent tissues ( P<0. 05 ) . Moreover, the expression of LC3 in moderately and poorly differentiated CRC was higher than that in well differentiated CRC, and the positive rate of LC3 in CRC with lymph node metastasis was higher than that in CRC without lymph node metastasis. The overexpression of mTOR was related to lymph node metasta-sis (P<0. 05), but both differentiation degree and lymph node metastasis were not associated with Beclin1 (P>0. 05). The expres-sion of LC3 was positively correlated with Beclin1 and negatively correlated with mTOR in colorectal cancer (rs =0. 593, P<0. 01, rs= -0. 165, P<0. 01), and the expression of Beclin1 was not associated with mTOR (P>0. 05). Kaplan-Meier survival analysis re-vealed that the five-year survival rate of patients without nodal metastasis, positive expression of Beclin1, LC3 and negative expression of mTOR was higher than those with nodal metastasis, negative expression of Beclin1 and LC3, and positive expression of mTOR. Cox survival analysis results revealed that LC3, mTOR and lymphnode metastasis were independent prognostic factors. The results of IHC, real-time PCR and Western blot in fresh CRC tissues indicated that the expression of Beclin1, LC3 and mTOR in colorectal cancer was significantly higher than that in adjacent tissues (P<0. 05). Conclusions The aberrant expression of Beclin1, LC3 and mTOR may be associated with the development and progression of colorectal cancer. The simultaneous detection of Beclin1, LC3 and mTOR genes in colorectal cancer may be helpful for the evaluation of the progressive degree and the judgment of prognosis.

Magnetic resonance imaging ( MRI ) findings were studied in 19 patients with non-dementia Parkinson′s disease ( PD) Hoehn-Yahr Stage 1 and 1.5 and 38 healthy subjects.The width and area of pars compacta of substantia nigra ( SNc) , substantia nigra ( SN) and midbrain were measured.The width and area ratios of SNc to SN were calculated.Compared with controls, the widths of right SNc was narrower, bilateral ratios of SNc to SN width were decreased in PD group.As to the area of substantia nigra, there was no significant difference between PD and controls.The width of left SN and the ratio of right SNc to SN width was negatively correlation with age of patients.The ratio of left SNc to SN width, the area of bilateral SNc and left SN, as well as the ratio of right SNc to SN area had negative correlation with the disease duration;however, there was no correlation with gender, Hoehn-Yahr Stage, the Unified Parkinson disease rating scale score, mini mental state scale, education years, levodopa equivalent daily dose, Hamilton Depression Scale or Hamilton Anxiety Scale in PD group.The results indicate that there are bilateral structural changes of SN in unilateral PD patients, which may be more significant with increasing disease duration.The measurement of SNc width and SN area can be used as an objective indicator for diagnosis and disease progression monitoring of PD.

Objective To investigate the prevalence of Helicobacter pylori (HP) infection in patients with Parkinson's disease (PD), and analyze the relationship of HP infection with the symptoms, disease progression and motor complications of PD.Methods 72 PD outpatients were randomly selected, and 100 gender and age-matched subjects who took health physical examination were considered as healthy controls.Basic data were collected and estimated by Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn and Yahr stage, the 39-item Parkinson' s Disease Questionnaire (PDQ-39), Activity of Daily Living Scale (ADL), Minimum Mental State Examination (MMSE), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA).All subjects underwent 13C-urea breath test to determine Helicobacter pylori infection status.Results There was no significant difference in H P infection rate between PD and control groups [37.5 ％ (27 cases)vs.32.0％ (32 cases), P=0.45].According to the initial symptoms, PD patients were divided into two groups: bradykinesia/ rigidity group and tremor group.The HP infection rate was higher in bradykinesia/rigidity group than in tremor group [52.2％ (12 cases) vs.30.6％ (15 cases)], but had no significant difference (P=0.08).The mean HY stage was higher in the HP-infected patient group than in the non-infected group [(2.6±0.7) vs.(2.2±0.9), P=0.03].The HP infection rate was higher in patients with HY stage ≥2 than with HY stage ＜2 [46.4％ (26 cases) vs.6.3％ (1 case),P=0.003].There were no correlations of HP infection with gender, age, age of onset, UPDRS, UPDRS-Ⅲ, PDQ-39, the course of the disease, wearing-off phenomenon, and dyskinesias.Conclusions The PD patients with HP infection are mainly at middle-and late-stage.HP infection may be related with the progress of the disease.It needs further study and validation by expanding the sample to investigate whether HP infection affects the motor complications.