Objective To study the behavioural changes and biological effects of selective adenosine A2A receptor antagonist (CSC) in a rat model of levodopa(L-DOPA) -induced dyskinesia (LID).Methods The hemi-parkinsonian rat model was produced by stereotaxically injecting 6-OHDA to the right medial forebrain bundle. Rats were randomly divided into 4 treatment groups with a random number generating program to receive intraperitoneal injections twice daily for 21 days (n = 10): saline, L-DOPA at 25 mg/kg with benserazide at 6. 25 mg/kg, CSC at 2. 5 mg/kg alone and CSC at 2.5 mg/kg with L-DOPA at 25 mg/kg plus benserazide at 6. 25 mg/kg. Forepaw adjusting steps, abnormal involuntary movements (AIM) and rotational response duration were observed on 2, 9, 11,18 and 21 d. After sacrifice, the expression of adenosine A2A R and mGluR5 was observed by Western blot. Results Co-administration of LDOPA with CSC significantly increased the forelimb adjusting steps of parkinsonian rats during 21 days of treatment when compared to L-DOPA alone. CSC treatment alone increased the forelimb adjusting steps significantly. Co-administration of L-DOPA with CSC ( ( 11 ± 5 ) score) significantly decreased the AIM scores of limb and orolingual muscles when compared to L-DOPA alone (( 17 ± 4) score; t = 2. 44, P ＜0. 05). The subchronic L-DOPA treatment upregulated the striatal expression of adenosine A2A R and mGluR5. However, co-administration of L-DOPA with CSC reversed the shortening of the rotational motor response duration induced by L-DOPA administration during the period of the treatment and attenuated the LDOPA-induced upregulation of adenosine A2A R and mGluR5 expressions. Conclusions CSC improves motor function in a hemi-parkinson rat model, potentiates the antiparkinsonian effects with L-DOPA and partly attenuates LID. Co-administration of L-DOPA with CSC reverses the L-DOPA-induced upregulated expression of A2A R and mGluR5, indicating the involvement of both A2A R and mGluR5 in the onset and progression of LID. Adenosine A2AR antagonists may be promising drugs for treatment of LID.

Objective To observe the feasibility and safety of self-made extended endobronchial tube applicated in one-lung ventilation for radical resection of esophageal cancer.Methods 80 patients were randomly divided into two groups:self-made extended endobronchial tube group (group A) and double-lumen endobronchial tube group (group B).The degree of lung collapse,systolic blood pressure,diastolic blood pressure,heart rate,airway pressure (Paw),arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),arterial oxygen saturation (SaO2) were monitored.The time for insertion,rate of successfully intubation for single time,incidence of postoperative hoarseness and sore throat were recorded.Results There were no significant differences in degree of lung collapse,systolic blood pressure,diastolic blood pressure and heart rate,SaO2 in the two groups(all P＞0.05).The comparison of the time for insertion between the two groups:(1.5±0.4)min vs.(2.6±0.8)min(t=4.78,P＜0.05);rates of successfully intubation for single time:95.0％ vs.80.0％(χ2=5.19,P＜0.05).The comparison of Paw between the two groups:T1:(17.3±1.1)cmH2O vs.(22.5±0.9)cmH2O,t=4.613,P＜0.05;T2:(17.9±0.5)cmH2O vs.(23.6±1.4)cmH2O(t=5.438,P＜0.05);T3:(18.1±0.8)cmH2O vs.(24.6±1.2)cmH2O(t=3.741,P＜0.05).The comparison of blood gas during one-lung ventilation between the two groups:PaO2(281.5±53.4)mmHg vs.(187.6±48.8)mmHg(t=5.28,P＜0.05);SaO2(98.1±6.3)％ vs.(94.5±5.7)％(t=3.46,P＜0.05);PaCO2(31.2±3.6)mmHg vs.(37.6±4.1)mmHg(t=6.32,P＜0.05).The comparison of incidence of postoperative hoarseness:1case vs.6cases(χ2=5.91,P＜0.05);The comparison of incidence of sore throat:4cases vs.13cases(χ2=6.13,P＜0.05).Conclusion Single-lung ventilation has achieved via either the double lumen tube or the self-made extended endobronchial tube.However,the self-made extended endobronchial tube is recommended for single-lung ventilation because of the advantages of its easy intubation and position,full oxygenation,low Paw,less incidence of postoperative hoarseness and sore throat.Self-made extended endobronchial tube can be used as a one-lung ventilation method in its indications.

Objective To research the relationship between Serum uric acid (SUA) levels and the Neu-trophil-to-lymphocyte Ratio (NLR) of Type 2 Diabetes Mellitus (T2DM) patients. Method 273 newly diag-nosed T2DM patients are selected in accordance with the WHO diagnostic criteria: Male subjects with SUA lev-els ≥ 416 μmol/L(70 mg/L), and female subjects with SUA levels ≥ 357 μmol/L (60 mg/L) are sorted into the high SUA (HUA) group (224 subjects), and the rest into the normal SUA (NUA) group (49 subjects). 100 subjects were selected as a control group. One-Way analysis of variance was applied to the data of the three groups; Pearson correlation analysis was used to calculate the correlation of SUA levels , NLR and IR; risk fac-tors influencing SUA levels were analyzed with Logistic regression analysis; ROC curve analysis was used to de-termine the diagnostic value of NLR to HUA, and the optimal threshold value of NLR. Result (1) The NLR and IR of the HUA group was significantly higher than those of the NUA group (2.54 ± 0.63 vs. 2.05 ± 0.61, P < 0.001; 3.70 ± 1.86 vs. 2.71 ± 1.43, P < 0.001); (2) In the HUA group, UA was positively correlated with NLR and IR (respectively r = 0.480, P < 0.001; r = 0.332, P < 0.001). (3)NLR (P < 0.001, EXP(B)= 8.045, 95%CI = 4.597 ~ 14.079) was a risk factor of Hyperuricemia. Conclusion Our results suggest that NLR may be an independent risk factor of Hyperuricemia.

Objective To evaluate the clinical outcome of fetus diagnosed as mild and moderate isolated ventriculomegaly(IVM)and its correlation with imaging follow-up. Methods Totally,161 cases of single pregnancy whose fetus was diagnosed as mild or moderate IVM by ultrasound were administrated. Data of prenatal ultrasound examination, pregnancy outcomes, and the postnatal MRI results were collected. New borns' growth and development, language expression, movement coordination, auditory and visual function were followed up to evaluate the neurodevelopment. Results (1)Before birth:80.1%(129/161) of IVM disappeared before the delivery, 16.1%(26/161)remained stable, and 3.7%(6/161)continued to deteriorate.(2)Postnatal MRI: 8 cases(9.6%, 8/83)were diagnosed IVM, of which 3 cases were found additional abnormalities(1 case was the corpus callosum dysplasia and 2 cases were leukodystrophy). The additional abnormal detection rate was 3/8.(3)Postnatal assessments: There were 7 cases(8.9%, 7/79) neunatal behavioral neurological assessment (NBNA), 6 cases (7.6%, 6/79) Bayley scales of infant development (BSID)-psychomotor developmental index(PDI) and 3 cases (3.8%, 3/79) BSID-mental development index(MDI) whose scores were low. There was no significant difference of the NBNA and BSID scores between mild and moderate IVM (NBNA: x2=2.042,P=0.210; BSID-PDI: x2=-1.359,P=0.174; BSID-MDI: x2=-1.205,P=0.228). Follow-up of 9 cases(11.4%, 9/79)with low BSID score, 6 of them were found to be stable in the medial ventricle of the uterus, and the size of the lateral ventricle was normal after birth by ultrasound and MRI. Conclusions The majority of IVM fetuses have good prognosis, but there is also a risk of neurodevelopmental dysplasia. The postnatal follow-up should be paid attention to, and MRI should be performed as the postnatal imaging evaluation.

Objective To analysis the common abnormalities in fetus with ventriculomegaly and clinical significance. Methods Collected from March 2010 to December 2016,298 cases of pregnant women whose fetus with ventriculomegaly and accepted the prenatal diagnosis of pregnancy,including 109 cases of isolated cerebral ventriculomegaly(IVM),and 189 cases of non-isolated cerebral ventriculomegaly(NIVM).They were divided into mild groups(10.0-11.9 mm),moderate group(12.0-14.9 mm)and severe group(≥15.0 mm)according to the width of the lateral ventricle. Results(1)The most common abnormality of the NIVM were neurodevelopmental system(37.30%,94/252);The second was ultrasonic soft index(27.78%,70/252).(2)The most frequent combi-nation in mild group was ultrasonographic soft mark anomalies(44.76%,47/105),followed by other ultrasonic indi-cators(18.10%,19/105).The abnormal incidence of central nervous system was higher in middle group(45.16%, 42/93),followed by ultrasonic soft index abnormality(21.51%,20/93).The abnormality of the central nervous sys-tem was 62.96%(34/54)in severe group,followed by an abnormal(14.81%,8/54).(3)There was a difference in the nervous system and the ultrasonic-soft indicator between the non-isolated lateral ventricle dilation with different lateral ventricle widths(P<0.001).There was no difference in cardiovascular abnormalities. Conclusion Prena-tal ultrasound revealed that fetus with cerebral ventriculomegaly should carefully examine whether other abnormali-ties existed to determine the prognosis of the fetus and whether intervention should be taken.There was a difference between the different types of lateral ventricle and the prognosis.

Objective To investigate the effects of metabotropic glutamate receptor 5 antagonist methyl-6-ethynyl-pyridine (MPEP) on behavior and striatal postsynaptic density-95 (PSD-95) protein expression changes in rats with levodopa-induced dyskinesia (LID).Methods Hemi-parkinsonian rat models were established by stereotaxically injection of 6-hydroxy dopamine (6-OHDA) in the right medial forebrain bundle;then,these 32 Parkinson's disease (PD) rats were randomly divided into four groups (n=8):levodopa (L-DOPA) treatment group,receiving L-DOPA 25 mg/kg+benserazide 6.25 mg/kg;saline group,giving the same volume of saline;MPEP treatment group,receiving 1.5 mg/kg MPEP;and L-DOPA+MPEP treatment group,accepted L-DOPA 25 mg/kg+benserazide 6.25 mg/kg+MPEP 1.5 mg/kg;All rats received intraperitoneal injections twice daily and continued for 21 days.At days 2,9,11,18 and 21,behavior changes of all rats were detected;the protein and mRNA levels of PSD-95 in striatal tissues were detected by Western blotting and real-time PCR,respectively.Results (1) Abnormal involuntary movement scores were significantly decreased in rats of L-DOPA+MPEP treatment group (42.33±12.43,41.80±13.69 and 40.30±9.76) as compared with those in L-DOPA treatment group (55.56±9.28,54.89±7.01 and 58.44±7.68) on days 11,18,and 21 (P＜0.05).Forepaw adjusting steps were significantly increased in Parkinson rats of L-DOPA+MPEP treatment group as compared with rats of L-DOPA treatment group (P＜0.05);and the increased extent was not decreased as time prolonging.Forepaw adjusting steps were also increased after MPEP treatment alone.Co-administration of L-DOPA with MPEP reversed the shortening of rotational response duration induced by L-DOPA.(2) The up-regulation of PSD-95 protein and mRNA levels in the lesioned striatum was noted in the L-DOPA treatment group (1.39 ±0.37 and 3.80 ±1.09),while this trend could be alleviated by coadministration of L-DOPA with MPEP (0.76±0.66 and 1.65±0.81).Conclusion MPEP can alleviate abnormal involuntary movements induced by L-DOPA and strengthen the anti-parkinsonian effect of L-DOPA,which may be related to regulation of striatal PSD-95 expression induced by L-DOPA.

Objective To investigate the expression characteristics of serum resistin(RETN)and Beclin-1 in patients with gouty arthritis(GA),and to analyze the relationship between RETN and GA clinical charac-teristics and clinical efficacy.Methods A total of 82 GA patients(GA group)and 60 healthy volunteers(con-trol group)in Dongguan People's Hospital from January 2019 to December 2022 were enrolled in the study.The expressions of serum RETN and Beclin-1 in GA patients were detected before and after treatment(on the physical examination day of the control group),and the differences of serum RETN and Beclin-1 in GA pa-tients with different clinical characteristics and efficacy were compared.Pearson correlation analysis was used to investigate the correlation between serum RETN,Beclin-1 expression and uric acid(UA)level in GA pa-tients.The diagnostic value of serum RETN and Beclin-1 in GA was analyzed using the receiver operating characteristic(ROC)curve.Results The serum RETN level in the GA group was higher than that in the con-trol group,and the expression of Beclin-1 was lower than that in the control group(P<0.05).The serum RETN levels in GA patients with acute stage,disease duration≥5 years,affected joints≥5,annual attack fre-quency≥3 times were higher than those in GA patients with chronic stage and intermittent stage,disease du-ration<5 years,affected joints<5,annual attack frequency<3 times(P<0.05),and the expression of Bec-lin-1 were lower than those in GA patients in chronic and intermittent stages,disease duration<5 years,af-fected joints<5,annual frequency<3 times(P<0.05).The serum UA level in GA patients was positively correlated with RETN(r=0.674,P<0.05),and negatively correlated with Beclin-1 expression(r=-0.568,P<0.05).After treatment,the serum expression of level RETN in the effective group was lower than that in the ineffective group,while the level Beclin-1 was higher than that in the ineffective group(P<0.05).The ar-ea under the curve of combined RETN and Beclin-1 diagnosis for GA was 0.921,which was higher than that of individual diagnosis(Z=3.752,3.154,P<0.05).Conclusion Serum RETN level increases,and Beclin-1 ex-pression decreases in GA patients,which is associated with increased UA level,prolonged acute stage and course of GA,increased number of affected joints and annual attack frequency,and treatment ineffectiveness.RETN and Beclin-1 could serve as biomarkers for GA diagnosis.

Objective To investigate pregnancy outcomes and neurodevelopment in fetuses with ventriculomegaly. Methods This was a cohort study of 173 gravidas with singleton pregnancy who were diagnosed with fetal ventriculomegaly by ultrasound in Prenatal Diagnostic Center of Nanfang Hospital Affiliated to Southern Medical University from March 2010 to July 2016. Thirty normal gravidas who received antenatal care in the same hospital and at the same period were selected as control. Clinical data were collected. Gravidas who had chosen to continue their pregnancy were followed up to monitor the variations of fetal ventricular. Fetal mild and moderate ventriculomegaly were respectively defined as a ventricular atrial width of 10-12 mm and >12 mm but <15 mm. Isolated ventriculomegaly (IVM) indicated those without any other ultrasound abnormalities, otherwise the case would be defined as non-isolated ventriculomegaly (NIVM). Among the 173 gravidas, 54 cases were mild IVM, 53 mild NIVM, 26 moderate IVM and 40 moderate NIVM. Fetuses with chromosome abnormalities were excluded from the study. Neonatal behavioral neurological assessment (NBNA) was used to analyze the neonatal neurodevelopment at the age of 7 days, and Bayley scales of infant development was used to evaluate the development of nervous system at the age of 6 months through analyzing their mental development index (MDI) and psychomotor development index (PDI). Statistical methods included t test, χ2 test (or Fisher's exact test), nonparametric test, Mann-Whitney test and multiple Kruskal-Wallis H test. Results (1) Among the 107 fetuses with mild ventriculomegaly, 72.9％ (78), 23.4％ (25) and 3.7％ (4) of them regressed, stabilized and progressed,respectively; however, among the 66 moderate cases, the figures were 45.4％ (30), 37.9％ (25) and 16.7％ (11) respectively (χ2=15.769, P<0.001). For those in the IVM and NIVM subgroups within the moderate ventriculomegaly group, significant difference was shown [17(65.4％), 8(30.8％) and 1(3.8％) vs 13(32.5％), 17(42.5％) and 10(25.0％), χ2=8.552, P=0.014], but not within the mild groups (χ2=2.412, P=0.299). (2) There were 164 gravidas who continued their pregnancy and delivered. Significant differences in NBNA score were observed between the ventriculomegaly group and the control (37.70±1.80 vs 38.53±1.38, t= - 2.424, P<0.05). Numbers of neonates with NBNA score < 36 and ≥ 36 points were 5(4.7％) and 101(95.3％) in the mild group, and 8(13.8％) and 50(86.2％) in the moderate group (χ2=4.231, P=0.004). There was significant difference in NBNA score between the IVM and NIVM subgroup within neither mild nor moderate group (χ2 were 0.210 and 0.201, P were 1.000 and 0.720). (3) Totally, 137 cases completed the assessment of nervous system development at the age of 6 months. There was significant difference in PDI score between the ventriculomegaly group and the control (90.50±10.85 vs 95.80±9.65, t= - 2.471, P=0.014), but not in MDI score (95.42+11.20 vs 99.50+12.00, t= - 1.786, P=0.076). (4) The comparison of the proportion of excellent, average and poor PDI scores: Significant differences were found between the IVM and NIVM subgroup within the moderate ventriculamegaly group and in the different intrauterine outcome groups [IVM vs NIVM groups: 3(15.0％), 16(80.0％) and 1(5.0％) vs 1(3.1％), 24(75.0％) and 7(21.9％),Z= - 2.097, P=0.036;intrauterine regression, stable and progress group: 9(10.6％), 75(88.2％) and 1(1.2％);3(6.5％), 37(80.4％) and 6(13.1％) vs 0, 2(2/6) and 4(4/6), χ2=19.808, P<0.001], but not between the mild and moderate vetriculamegaly group, or between the subgroups within the mild ones (Z were - 1.869 and - 1.946, P were 0.062 and 0.052). (5) The comparison of the proportion of excellent, average and poor scores of MDI: Significant difference was only found among the different intrauterine outcome groups[13(15.3％), 71(83.5％), 1(1.2％); 2(4.4％), 41(89.1％), 3(6.5％) vs 0, 5(5/6), 1(1/6); χ2=7.980, P=0.018], but not in any other comparisons (all P>0.05). Conclusions Prognosis of fetal ventriculomegaly is affected by co-existed abnormalities and intrauterine progression. Fetus with mild ventriculomegaly can also have risk of abnormal neural development, suggesting that we should pay much attention to such cases and a regular follow-up is required.

Objective :To explore rehabilitative effect of low—frequency (1Hz ,LF) repetitive transcranial magnetic stimulation (rTMS) combined functional electrical stimulation (FES) on lower limb spasm and motor function in pa—tients with subacute ischemic stroke (SAIS).Methods : A total of 92 SAIS patients with lower limb spasm and motor dysfunction hospitalized in our department were randomly divided into sham stimulation + FES group (sham stimu—lation group ,n＝45) and low—frequency rTMS + FES group (LF—rTMS group ,n＝47) ,both groups were continu—ously treated for three weeks .Lower limb motor function and spasm severity were assessed by Fugl—Meyer motor as—sessment (FMA) and modified Ashworth scale (MAS) respectively before and after treatment ,and motor evoked potential (MEP) was detected .Results : Compared with before treatment ,there was significant rise in FMA score , and significant reductions in MAS score and MEP in two groups after three—week treatment , P＝ 0.001 all ;com—pared with sham stimulation group ,there was significant rise in FMA score [16. 0 (13.0 ,23. 5 ) scores vs. 19. 0 (16.0 ,27.0) scores] ,and significant reductions in MAS score [1. 5 (1. 3 ,1.5) scores vs. 1. 0 (0. 5 ,1. 5) scores] and MEP [ (24.64 ± 0. 39) ms vs. (24.43 ± 0.31) ms] in LF—rTMS group after treatment , P＜0.05 or ＜ 0. 01 . Conclusion : Compared with sham stimulation + FES ,LF—rTMS + FES can more significantly improve lower limb spasm and motor function in patients with subacute ischemic stroke .

Objective To investigate the prevalence of restless legs syndrome (RLS) in peritoneal dialysis patients and analyze the related risk factors.Methods This study was a cross-sectional study.The patients receiving maintenance peritoneal dialysis from January 2017 to December 2017 in the Peritoneal Dialysis Center of the Second Hospital Affiliated to Soochow University were selected as the study subjects.RLS was screened for peritoneal dialysis patients by epidemiological field investigation based on the RLS diagnostic criteria of the International Restless Leg Syndrome Research Group in 2014.Clinical data and laboratory examinations of selected patients were collected and the differences of clinical indicators between RLS and non-RLS patients were compared.The risk factors related to RLS were analyzed by logistic regression.Results Seventy-six cases of RLS were screened out from 396 PD patients.The prevalence of RLS was 19.2％.Compared with non-RLS group,RLS group patients had longer dialysis age,less 24 hours urine volume,and elevated blood intact Parathormone (iPTH) and alkaline phosphatase (AKP) (all P ＜ 0.05).There was no significant difference in primary disease ratio,sex,age,body mass index,blood pressure,hemoglobin,creatinine,urea nitrogen,uric acid,ferritin,serum iron,transferrin saturation,blood calcium,blood phosphorus,total cholesterol,triglyceride,low density lipoprotein,high density lipoprotein,eGFR,Kt/V,Ccr between RLS and non-RLS group patients (all P ＞ 0.05).Multivariate logistic regression analysis showed that long dialysis age (OR=1.010,95％CI 1.001-1.018,P=0.022) and high blood AKP (OR=1.005,95％CI 1.001-1.010,P=0.021) were independent risk factors for RLS in peritoneal dialysis patients (both P ＜ 0.05).Conclusions The prevalence of RLS is high in peritoneal dialysis patients.Long dialysis age and high blood AKP are independent risk factors for RLS.