Objective To assess cognitive impairment of patients with idiopathic Parkinson's disease(PD)of different clinical subgroups. Methods The cluster analysis approach was used to classify PD patients on the basis of their clinical features, and then compare their cognitive function according their Montreal Cognitive Assessment (MoCA)score. Results One-hundred and six patients were divided into 5 groups by means of cluster analysis:A. young-onset(n = 35), B. rapid disease progression(n = 6); C. tremor dominant(n = 36), D. haplo-non-tremor dominant(n =18),E. non-tremor dominant with depression(n = 11). The MoCA score and proportion of abnormal scores differed among the 5 groups significantly,especially between the subgroup E(19.00 ±5.47)and the subgroup A(23. 66 ± 3.51)(P ＜ 0. 05), the former was more seriously impaired in clock drawing task(1.73 ± 1. 01 vs.2. 66 ±0. 59 ,t = -2. 904,P =0. 013), alertness(0. 55 ±0. 52 vs. 0. 91 ±0. 28 ,t = -2. 241 ,P =0. 045),semantic fluency(0. 64 ±0. 51 vs. 0. 97 ±0. 17 ,t = -3. 429,P =0. 001)and orientation domains than the latter(4. 91 ± 1.38 vs. 5.80±0.47,t = -3.321,P =0.020). Conclusions The cognitive impairment in PD patients are common as well as heterogeneous.

Objective To investigate the risk factors of Parkinson's disease(PD)with mild cognitive impairment and mode of cerebral glucose metabolism. Methods One hundred and one non-dementia PD patients were assessed with Montreal Cognitive Assessment(MoCA)and divided into the PD with mild cognitive impairment (PD-MCI)group and the PD non-cognitive impairment(PD-NC)group. The demographic details, clinical features,Unified Pakinson's Disease Rating Scale(UPDRS), Hohen-Yahr rank and Hamilton Depression Scale(HAMD)were compared between the two groups. Patients in Hohen-Yahr stage 1 underwent positron emission tomography(PET)with 18F-fluorodeoxyglucose(18F-FDG)to show glucose metabolism. Results Seventy-seven(74. 3%)PD patients had mild cognitive impairment PD-MCI group had higher score in UPDRS 1st(mentation ,behavior and mood),2nd (activity of daily living)and 3rd(motor examination)subscale(2.48 ± 1.51,10. 71 ± 4. 88,22.31 ± 12.70)than PD-NC group(1.65 ± 1.29,8.15 ±2. 20,15.92 ±7.56,P ＜0.05)respectively. The FDG metabolism ratio of frontal cortex,parietal cortex and occipital cortex decreased more significantly in PD-MCI than in PD-NC(P ＜ 0.05).Conclusions The risk factors of mild cognitive impairment in PD include moter dysfunction, clinical stage and depression. The metabolic dysfunction of cortex may be the mechanism of mild cognitive impairment in PD.

Objective To compare the ability of Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) in screening cognitive impairment in early stage of Parkinscn disease (PD). Methods The cognitive function of 101 patients with Parkinson disease (Hohen-Yahr stage 1-3) was assessed with MMSE. Ninety-six patients defined as having a normal age- and education-adjusted MMSE score were assessed subsequently with MoCA. The 96 patients were divided into two groups according to cut-off points of 26 of MoCA. The performance of cognitive domain was compared between PD-MCI group (MoCA <26) and control group (MoCA≥26). Results Mean MMSE and MoCA scores (standard deviation) were 27.17 (2.69) and 22.60(4.42) , respectively. 75% of the patients with normal MMSE scores had cognitive impairment according to their MoCA score. The PD-MCI group had lower scores in numerous cognitive domains (visuospatial and executive abilities, naming, attention,language, ab-straction, delayed memory) compared with control group (PD-MCI group: 3.11±1.40,2.56±0.69,5.07±1.05, 1.69±0.85,1.08±0.84, 1.08±1.31 ;Control group:4.75±0.61,2.92±0.28,5.88±0.45,2.46±0.66, 1.92±0.28,3.50±0.78, P<0.05). Predictors of cognitive impairment on the MoCA using univariate analyses were gender, age, education, Hoehn-Yabr stage, Unified Parkinscn Disease Rating Scale, depression severity (HAMD) and hallucination (r was-0.205,-0.209,0.263,-0.352,-0.225,-0.293 and-0.218, respectively). Condusions The MoCA is a more sensitive screening than the MMSE for cognitive impairment in early stage of PD.

Objective To investigate the clinical heterogeneity of Parkinson's disease in the early stages.Methods Clinical data of demographic,motor phenotype,disease progression,cognitive,mood,autonomic and hallucination variables were collected from 143 patients with PD in the early stages.The patients' subtypes were explored with statistical cluster analysis of the clinical data.Results The analysis indicated four main subtypes:1.the younger-onset subtype(n=40);2.The tremor dominant subtype(n=57);3.the non-tremor dominant subtype with fast progression(n=17);4.The non-tremor dominant subtype with mild depression(n=29).Age at onset,posture-instability scores,the ratio of tremor scores to non-tremor scores,rate of progression and apathy scores all differentiated patients of respective subgroups.Conclusion The patients with early Parkinson's disease have marked heterogeneity in the clinical phenotype.

Objective To evaluate the effect of continuous dopaminergic stimulation on the non-motor symptoms. Methods Fifty-eight patients with Parkinson's disease(PD) following motor fluctuation and non-motor symptom were enrolled in this study. The subjects were treated with levodopa/carbidopa and entacopone for eight weeks. The scores of NMSS, PD fatigue scale, HAMD and Pittsburgh Sleep Quality Index (PSQI) were compared between baseline and endpoint.Results The total scores of NMSS decreased significantly from baseline to endpoint (P<0.05). The scores of endpoint were significantly lower than those of baseline in the urinary, sexual function, depression/anxiety and sleep/fatigue subscale of NMSS; however, there was no significant difference between baseline and endpoint in the gastrointestinal, cardiovascular, hallucination/delusions, attention/memory subscales of NMSS. The scores of endpoint were significantly lower than those of baseline in HAMD, PD fatigue scale and PSQI.Conclusion The continuous dopaminergic stimulation treatment with levodopa/carbidopa and entacapone may improve some respects of non-motor symptom of PD.

Objective To separate human γ-tubulin ring complexes (γTuRC) .Methods Cell lysates prepared from 293FT cells were separated using gel filtration chromatography .Then, the eluate fractions containing γTuRC or γ-tubulin small complexes (γTuSC ) were determined by immunoblotting .Results As the constitutive components of γTuRC,γ-tubulin,γ-tubulin complex protein 2 (GCP2), GCP3 and GCP4 were eluted and enriched in the fourth fraction .The molecular mass of eluates in the fourth fraction was about 2000 ×10 3 .Following γTuRC, the constitutive components ofγTuSC including γ-tubulin, GCP2 and GCP3 were eluted and enriched in the fourteenth fraction .The molecular mass of eluates in the fourteenth fraction was about 310 ×10 3 .Unassembled free components were washed out in the eighteenth and subsequent fractions .γTuRC could be detected in the corresponding fractions by negative-PAGE separation .ConclusionγTuRC and γTuSC were successfully separated from the unassembled free components in the fourth ( 4#) and fourteenth (14#) eluted fraction, respectively.The eluates containing ofγTuRC orγTuSC can be used for microtubule assembly research.

Objective To investigate the relationship between fatigue and motor dysfunction in patients with Parkinson's disease(PD).Methods 139 PD patients were assessed with Fatigue Severe Scale(FSS) and divived into the fatigue group and non-fatigue group. The motor function, depression and cognitive function were assessed with Unified Pakinson's Disease Rating Scale(UPDRS), Hamilton Depression Scale and mini-mental state examination(MMSE) respectively. The Spearman's rank correlation coefficient was used to evaluate the correlation between fatigue and motor dysfunction.Results 70 patients had fatigue. The UPDRS motor subscale score of the fatigue group was significantly higher than the non-fatigue group (P<0.05). The UPDRS score of rigidity items and bradykinesia items of the fatigue group were significantly higher than those of the non-fatigue group(P<0.05), with no significant difference in UPSRS score of tremor items between the two groups (P>0.05). There was significant correlation between FSS score and UPDRS motor score (P<0.05). Conclusion Fatigue is one of the common symptoms of PD and correlates with motor dysfunction.

ObjectiveTo explore whether the biocompatibility of phosphorylcholine (PC) modified alginate-chitosan microcapsules could be improved. MethodsPC modified alginate-chitosan microcapsules were obtained by high-voltage electrostatic system.Bradford method was adopted to determine the adsorption amounts of bovine serum albumin by chitosan alone and PC modified chitosan.Alginate-chitosan-PC microcapsules (experimental group) and alginate-chitosan microcapsules ( control group) were respectively implanted into the peritoneal cavity of mice and retrieved 4 weeks after transplantation.Fibrosis of the capsules was evaluated by HE staining.Glucose stimulated insulin secretion (GSIS) assay was used to assess the insulin secretion response of encapsulated and nonencapsulated rat islets. Results The adsorption amount of protein was 189.4 μg/mg and 90.5 μg/mg respectively by chitosan alone and PC modified chitosan.The difference had statistical significance ( t =5.549, P ＜ 0.05 ).In contrast to the control group, the cellular reaction on the surface of the modified microcapsules was weaker, with no obvious fibrosis found.The insulin secreted by encapsulated islets and nonencapsulated islets was( 3.298 ± 1.680 ) μIU/ml VS (4.299 ± 1.159 ) μIU/ml ( t =1.096, P ＞ 0.05 ) in response to low-glucose stimulus and( 11.783 ± 4.175 ) μIU/ml VS ( 12.875 ± 2.268 ) μIU/ml ( t =0.514, P ＞ 0.05 ) in response to high-glucose stimulus.Conclusions PC can improve the biocompatibility of alginate-chitosan microcapsules, with no effect on the biological function of encapsulated islets.It may be more appropriate to use modified microcapsules encapsulating islets for transplantation.

Objective To evaluate the feasibility of sentinel lymph node biopsy(SLNB)during surgery of breast cancer. MethodsRadioactive colloid and blue dye were injected intradermally around the tumor seperately before the operation and the SLN were detected first by lymph scintigraphy. SLN was detected and located using ?-finder and the blue dye. Axillary lymph node dissection(ALND)was performed routinely after the SLNB. Results Among 116 breast cancer patients,this procedure was successful in 98.3% of cases. The sensitivity, accuracy and false negative rate were 93.6%, 97.4% and 6.4%, respectively. Conclusions SLNB is a simple, safe and reliable technique.Routine ALND could be raplaced by SLNB in breast cancer patients undergoing surgery.

[Summary] A case of primary hyperparathyroidism ( PHPT ) complicated with Graves′disease was reported.The parathyroid lesion( s) could not be identified by repeated MIBI and ultrasonography tests.With the control of hyperthyroidism, medical therapies of hypercalcemia were still not effective, the serum calcium levels continued to be high.Thus, the decision to operate was made.The pathological findings confirmed the diagnosis of parathyroid adenoma.For PHPT patients with clear surgical indications, even though the pre-operative localizing tests are negative, operation is still worth to try.