Objective To observe the correlation between physical fatigue and motor function in patients with Parkinson's disease (PD). Methods The 36 patients (12 females, 22 males) with PD were elected from PD clinic in Beijing Hospital, and 18 health controls of age and gender matching were enrolled. The Parkinson Fatigue Scale (PFS), the timed get up and go test and the six-minute walk test were used to evaluate the disease progress, physical fatigue and motor function. The correlation between PFS score and motor function was analyzed. Results There were significant differences between patients with PD and healthy controls in PFS score, get up and Go performance time and the max six-minute walk distance (P＜0.05). In patients with PD, the PFS score was positively correlated with get up and go performance time (r= 0.82, P＜0. 01 ), and was negatively correlated with distance of six-minute walk (r= -0. 61, P＜0. 01). Conclusions Patients with PD show more fatigability and decreased motor function compared with healthy people of age and gender matching; The severity of physical fatigue symptom of patients with PD shows positive correlation with get up and go performance time, and negative correlation with the distance of six-minute walk.

Objective To assess gastric emptying of mixed meal in patients with diabetes mellitus (DM) and small intestinal transit of solid meal.Methods Gastric emptying of solid and liquid food,and small intestinal transit time of solid food were measured in patients with DM by a dual isotopic technique.Anterior and posterior images were recorded by SPECT.Results The average time of 50% gastric and proximal gastric emptying of solid food and the maximal counting time of distal gastric solid food were much longer in patients than those in controls.About 40%-44% patients exceeded normal range.The change of the average time of delay phase was not significant,but 48% patients exceeded normal range;the change of gastric emptying of liquid food was not significant.But in patients,the small intestinal transit time of solid food was significantly longer than that of healthy controls.Conclusion The average transit time of solid meal in DM patients is longer,but their gastric emptying of liquid food is normal.

Objective To explore the clinical efficacy of laparoscopic resection for large volume of adrenal tumor.Methods Eighty patients with adrenal tumor who were treatment by laparoscopic resection were divided into large volume group (diameter ≥ 6 cm) and small volume group (diameter ＜ 6 cm) according to the size of the tumor.The intraoperative and postoperative complications of the two groups were compared.Results The operation time,intraoperative bleeding volume and postoperative hospitalization time of large volume group were significantly higher than those in small volume group:(187.4 ±39.2) min vs.(153.7 ± 31.6) min,(458.2 ± 87.3) ml vs.(105.9 ± 25.1) ml and (10.9 ± 2.7) d vs.(7.3 ± 1.5) d,and the difference were statistically significant (P ＜ 0.05).The postoperative complications in two groups had no significant difference:10.3％ (4/39) vs.7.3％ (3/41),P ＞ 0.05.Conclusion The laparoscopic resection for large volume of adrenal tumor have the advantages of less invasion,faster recovery and less complications,and it has become the main mode of treatment.

Objective To observe the effect of early goal directed therapy (EGDT) on tissue perfusion,microcirculation and oxygen metabolism in patients with septic shock.Methods A prospective observational study was carried out in 69 patients with early septic shock within 24 hours.The eligible patients were treated with the standard procedure of EGDT.The partial pressure of transcutaneous oxygen (PtcO2) and transcutaneous carbon dioxide (PtcCO2) was monitored and the changes of hemodynamic data,tissue oxygen,microcirculation before and after reaching the criteria of EGDT were recorded.Results Compared with that before treatment,PtcO2,tissue oxygenation index (PtcO2/FiO2) after EGDT was increased [(78.1 ± 30.8) mmHg (1 mmHg =0.133 kPa) vs.(62.8 ± 24.1) mmHg and (141.7 ± 78.3) mmHg vs.(110.8 ± 60.5) mmHg],PtcCO2 and percutaneous arterial carbon dioxide partial pressure difference was decreased[(29.0 ±4.1) mmHg vs.(39.1 ±6.4) mmHg and (1.4 ±0.5) mmHg vs.(1.7 ±0.8) mmHg],there was significant difference(P＜ 0.05).There was no significant difference in PtcO2,PtcO2/FiO2,PtcCO2,central venous blood oxygen saturation,lactic acid,oxygen and oxygen consumption (P ＞ 0.05).Conclusion EGDT can improve local tissue perfusion and microcirculation in patients with septic shock,body tissue perfusion index before and after EGDT may not be able to reflect the local tissue perfusion.

Objective To study the optimal dose and reaction time of human leukocyte antigen B27(HLA‐B27)antibody in flow cytometry .Methods Take 52 cases of whole blood in patients with ankyl‐osing spondylitis(AS) .According to HLA‐B27 antibody doses ,samples were divided into two groups:5 μL group and 10 μL group .HLA‐B27‐positive rate were tested after 5 ,10 ,15 min , respectively .Results The HLA‐B27 positive rate of 5 μL group at different reaction time were (84 .16 ± 1 .21)% ,(94 .81 ± 1 .33)% ,(94 .10 ± 1 .26)% ;the positive rate of 10 μL group at different reaction time were (85 .40 ± 1 .27)% ,(96 .76 ± 1 .31)% , (95 .36 ± 1 .45)% .The positive rate of HLA‐B27 in 10 μL group was higher than 10 μL group(F=90 .08 ,P<0 .05) .The positive rate of HLA‐B27 after reacting for 10 and 15 min were higher than that after reacting for 5 min(F=60 .25 ,P<0 .05) .There was not statistically significantly different between the reaction time of 10 min and 15 min(F=1 .08 ,P>0 .05) .Conclusion The opti‐mal dose and reaction time of HLA‐B27 antibody in flow cytometry are 10μL and 10 min;There is not any interaction between anti‐body dose and the reaction time of HLA‐B27 antibody .

Objective To observe the influence of comprehensive rehabilitation on lung function and exercise tolerance in geriatric patients with chronic obstructive pulmonary disease (COPD).Methods Totally 51 patients with COPD were enrolled in this study and divided into two groups:treatment group and control group.For treatment group,each patient was given health education about COPD and the rehabilitation program with medication therapy.The program included aerobic exercises,breathing exercises and upper limb strength training.The control group was given medication therapy only.The treatment group was tested by 6 minute walking distance (6MWT) and both groups had lung function examination before the program started,and were retested 1 year later.Results In the treatment group,lung function including vital capacity (VC),forced expiratory volume in one second (FEV1),FEV1 ％,and 6MWT were significantly improved after 1 year of treatment as compared with those indices before treatment [(2.94±0.67)L vs.(2.62±0.65) L,(2.88±0.70)L vs.(2.58±0.65)L,(1.89±0.79)L vs.(1.60±0.67)L,(80.7±28.3)％ vs.(67.7 ±25.9)％,(426.40±71.37)m vs.(326.23±110.80)m,t=2.86,2.27,4.28,4.73,-3.639,respectively,P=0.006,0.027,0.000,0.000,0.001].There was no significant difference in lung function before versus 1 year after intervention in the control group.After 1 year of intervention,the only difference was in FEV1 ％ between the treatment and control groups [(80.7±28.3)％ vs.(71.90± 16.5) ％,t=9.88,P=0.000].Conclusions Comprehensive rehabilitation can improve the lung function and exercise tolerance in geriatric patients with COPD.

Objective To evaluate diagnostic value and clinical significance of procalcitonin (PCT)in infection in intensive care unit (ICU)patients.Methods 96 ICU patients in a hospital between September 2011 and March 2012 were selected for study,levels of patients’PCT,high-sensitivity C-reactive protein (HsCRP)and white blood cell (WBC)count were detected,statistical analysis were conducted.Results Compared with non-bacteria infected patients,serum PCT and HsCRP levels in all bacteria infected patients increased,the difference were significant (Z=-6.102;-3.918,both P <0.05 );WBC count was not significantly different(Z =0.212.P >0.05).PCT sensi-tivity,specificity,positive predictive value,and negative predictive value for diagnosing infection was 82.35%, 67.86%,86.15%,and 61 .29% respectively;receiver operating characteristic (ROC)curve of PCT,HsCRP,and WBC was 0.898,0.755,and 0.581 respectively.Conclusion There are higher sensitivity and specificity of PCT to predict infection,which is helpful for early detection of infection in critically ill patients.

We aimed to examine the effect of pioglitazone on transdifferentiation of preosteoblasts from rat bone marrow mesenchymal stem cells (BMSCs) into adipocytes and investigate its effect on bone metabolism. BMSCs were harvested from the femurs and tibias of a rat, then separated, purified, proliferated for 3 generations and differentiated into preosteoblasts for 5 days and 14 days respectively in the presence of osteogenic medium. Thereafter, the preosteoblasts were cultured for 21 days in the presence of adipogenic medium with and without pioglitazone (1 μg/mL). Partially-differentiated osteoblasts were identified by mineralized nodules with Alizarin red S staining. Transdifferentiated adipocytes were identified by Oil Red O staining. Reverse transcription PCR (RT-PCR) was performed to assay the expression levels of osteogenic markers Runx2 and ALP, and an adipogenic marker PPARγ. Those cells cultured for 5 days did not show mineralized nodules as detected by staining of Alizarin red S, while those cultured for 14 days showed dispersed mineralized centers in the form of brown spots, although without obvious red mineralized nodules. After adipogenic transdifferentiation for 21 days, adipose-drops were found in cells of 5CG and 5EG earlier than those of 14CG and 14EG, and the former showed much more adipocytes separately as detected by Oil Red O staining. Whatever the time was 5 days or 14 days of BMSCs osteogenic differentiation, the cells cultured with pioglitazone showed much more adipocytes than those without pioglitazone. Our experiment showed that the less time it took for BMSCs osteogenic differentiation, a stronger ability remained for BMSCs to transdifferentiate into adipocytes. The mRNA expression levels of Runx2 and ALP were decreased by 1.79 and 1.90 times respectively in 5EG (P< 0.05) as compared with 5CG, and that of PPARγ was increased by 1.31 times in 5EG (P<0.05) as compared with 5CG. The mRNA expression levels of Runx2 and ALP were decreased by 1.45 and 1.54 times respectively in 14EG (P<0.05) as compared with 14CG, and that of PPARγ was increased by 1.39 times in 14EG (P<0.05) as compared with 14CG. It was concluded that pioglitazone stimulated the transdifferentiation of BMSCs into adipocytes. These observations provided a potential mechanism of imbalance in thiazolidinedione induced bone metabolism.

Objective: To evaluate economic benefits of military medical measurement. Methods: According to the record of the metrological verification from the measurement station in Nanjing military region from 2000 to 2004, database is set up by Excel 2003 and the economic benefits from 14 kinds of measuring standard are analyzed. Results In a 5-year-lifetime cycle, the NPV of 10 kinds of measuring standards were over 0, 4 kinds less than 0, the average pay back period was 4.43year, and total benefit cost ratio was 2.73. Conclusion Economic benefits have been gained obviously in the investment of military medical measurement.

Limb rehabilitation is one of the key issues for improving the quality of life in patients with stroke. Studies have demonstrated that the retention and recovery of active movement of hemiplegic limb have predictive value for the prognosis in acute stroke. The responsible lesion sites and rehabilitation training in the acute phase may be an important factor in influencing the recovery of active movement ability of hemiplegie upper limb. However, there is still lack of a large, multi-center study, and further related studies are needed.