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.

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Humans ; Hypertension, Pulmonary ; metabolism ; Inhibitor of Apoptosis Proteins ; Microtubule-Associated Proteins ; metabolism

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 explore the blood drug concentration monitoring of sustained-release valproate(DK)in children with epilepsy,focusing on the selection of sampling time and evaluation of the results.Methods Two hundred and seventy-one children taking DK and 155 children taking sodium valproate syrup(VPA Syr)were involved and their serum were taken when achieved steady state to determine the valproic acid level using fluorescence polarization immunoassay.They were divided into 4 groups,which were DK taken once daily group(DK qd group,126 children),DK taken once daily at night and sampled on morning group(DK qn group,26 children),DK taken every 12 h group(DK q12 h group,119 children),VPA Syr q12 h group(155 children).Determine the proportion of the blood drug concentration of each group below,ithin and above the therapeutic range for valproate(50-100 mg/L)were determined.The data were analyzed by t test.Results The Cmin of DK qd group were(73.09?19.91)mg/L,significantly lower from the serum concentration of DK qn and sampled on morning group [(94.94?25.44)mg/L](P0.05).Conclusions DK qn should sampled at night before the night dose.The Cmin of DK q12 h was higher according to the therapeutic range,it's favorable range still needs clinical practice.

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 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.

Glucose was transported by the large number of hexose transporters in yeast cells. There were 18 hexose transporter genes had been identified in Saccharomyces cerevisiae. However,as an excellent expression system,there was no information of these genes had been reported in Pichia pastoris. Based on high homologous recombination efficiency in yeast,we chose G418 resistance for screening,200 bp were cloned from the up and down sequences of HXT1 ORF respectively,then ligated to the 5′ and 3′ end of G418 resis-tance gene for recombination. After electroporation of GS115 spheroplast and screened through different G418 concentration plates,finally we obtained one HXT1 gene deletion mutant named GS115?HXT1. The growth rate and glucose consumption of this mutant were both lower than the wide type.