Objective To research the clinical rehabilitative effect of repeated transcranial magnetic stimulation (rTMS) for the non-motor symptoms of Parkinson's disease.Methods Fifty-five PD patients were randomly divided into an rTMS treatment group (n =29) and a sham stimulation group (n =26).The treatment group received a course of 0.5 Hz rTMS treatment,while the sham stimulation group had the same treatment but with no energy output.Both groups were evaluated using a non-motor symptoms questionnaire (NMSQuest),the Hamilton depression scale (HAMD),the Pediatric Daytime Sleepiness Scale (PDSS),the mini-mental state examination (MMSE) and the scale for outcomes in PD for autonomic symptoms (SCOPA-AUT) before treatment,immediately after,and a month after treatment.Results Compared with before treatment,the average NMSQuest score of the treatment group declined significantly,though 1 month after treatment the improvement was no longer significant.After treatment and 1 month later the average NMSQuest score of the sham stimulation group increased gradually.The effect in the treatment group was therefore significantly better than in the sham stimulation group.After treatment and 1 month later the average HAMD score of the treatment group was significantly lower than before treatment while the average HAMD score of the sham stimulation group had increased gradually.The improvement in depression in the treatment group was therefore significantly better than in the sham stimulation group.After treatment,sleep disorders in the treatment group had been significantly alleviated,but one month later the improvement was no longer significant compared with before treatment.PDSS scores in the sham stimulation group declined gradually,but the improvement in sleep disorders among the treatment group was significantly better than among the sham stimulation group.Cognition improved significantly among the treatment group right after treatment,but 1 month later it had worsened while the MMSE scores of the sham stimulation group decreased gradually.The difference between the two groups was statistically significant.The average SCOPA-AUT scores of the two groups were not significantly different from each other or from the scores before treatment.Conclusion Repeated TMS can improve most non-motor symptoms of PD.The improvement in depression is the most significant.A short course of rTMS has no obvious rehabilitative effect on the autonomic function disorders of PD patients.

Objective To explore factors related to the development of segmental instabilities in lumbar spine. Methods Fifty-seven patients with lumbar segment instabilities at L 4～5 were selected as illness group, 22 patients with facetectomy at L 4～5 as post-operation control group, and 19 healthy subjects as normal control. X-ray plain films were taken in sagittal,flexion and extension positions. Computed tomographic scans were taken to define the axial morphology of the facet joint. Magnetic resonance scans were taken to describe disc degeneration of 36 patients in illness group. Results The facet joint was oriented sagittally in the forward translation patients in flexion. The disc degeneration was slight in the rotational instability patients. The patients with total facetectomy exited forward translation in flexion. Conclusion A more sagittally oriented facet and disc degeneration are associated with forward translation in flexion and may be the cause of degenerative spondylolisthesis, whereas ligament failure is associated with rotational instability.

Objective To study the effects of complex polysaccharides immune milk (CPIM) on cellular and humoral immune functions in mice. Method Sixty ICR mice were divided into five experimental groups and a control group. The mice in experimental groups were given i.p. Ganoderma lucidum polysaccharide (GLP) immune milk,Lycium barbarum polysaccharides (LBP) immune milk and different doses (low,medium and high) CPIM,and the control group was given equivalently skimmed and sterilized goat's milk respectively for 15 d. The cellular and humoral immune functions and the feces were examined. Results Transformation ability of spleen lymphocytes:There were highly marked differences between all experimental groups and control group,between medium dose group of CPIM and GLB group,LBP group (P

Objective To evaluate the effect of the transcranial magnetic stimulation on upper-extremity function rehabilitation and changes in the excitability of cerebral cortex,and to evaluate from the viewpoint of electro-physiology the prognosis so as to guide the rehabilitation treatment of patients after stroke.Methods Forty-six patients in the early stage after a stroke were given TMS examinations of the ipsilateral brain region.Those with the motor evoked potentials (MEPs) amplitudes lower than 50 μV were classified into a motion-induced experimental negative group (the negative group),whiie those whose MEP amplitude reached 50 μV or more were classified as movement-induced positive (the positive group).Both groups were given the same treatment.Before and after 2,4 and 8 weeks of treatment the Fugl-Meyer movement function rating scale was used to assess their bilateral upper limb movement function.TMS technology was used to detect any change in the resting motor threshold (RMT) and the amplitude (Amp) of MEPs in the motor cortex.The incubation period of the cortex (CL) and the central motor conduction time (CMCT) in the contralateral motor cerebral cortex were also observed.Results After 4 weeks of treatment,the average score of the positive group on Fugl-Meyer upper movement function rating scale reached (54.99±2.76),significantly higher than before treatment and significantly higher than the negative group's average (P＜0.05).After 8 weeks of treatment,the average score in the positive group had increased further to 73.11±2.98,still significantly higher than that of the negative group (P＜0.01).After treatment,RMT decreased progressively in both groups,but that of the negative group dropped from (98.35±10.12) to (30.35±7.31) (9＜0.01),with significantly greater decline in amplitude and rate than that of the positive group (P＜0.05).After treatment,the Amp of both groups showed a gradual increasing trend.Amp increased earlier in the positive group,but there was no significant difference in the extent of the increase between the two groups (P＞0.05).After the treatment the CL and CMCT had shortened significantly in the negative group compared to before the treatment (P＜0.05),while there was no significant change in CL and CMCT after the treatment (P＞0.05).Conclusions The excitability of the contralateral motor cortex changes after a stroke.TMS can be used to characterize the MEP to monitor and predict recovery.This should help clinicians prepare more scientific rehabilitation plans.

Objective To evaluate the effect of injecting botulinum toxin A (BTX-A) to the external urethral sphincter on detrusor wall thickness (DWT) and the bladder function of spinal cord injury patients with detrusor-sphincter dyssynergia (DSD).Methods Twenty-one adult patients with DSD due to spinal cord injury were recruited.A single 100 IU dose of botulinum toxin A was injected into their external urethral sphincters via an uhrasound-guided transperineal route.DWT,detrusor leak-point pressure (DLPP),post-void residual volume (PRV) and maximum bladder capacity(MBC) were assessed by urodynamic examination and ultrasound evaluation before and 4 and 8 weeks after the injection.Results Four weeks later a significant decrease in PRV was observed,but no significant difference in DWT,DLPP or MBC.After eight weeks the mean DWT value had decreased by 17％,a significant reduction.There were also significant improvements in DLPP,PRV and MBC at eight weeks compared with the of baseline values.Conclusions BTX-A injection to the external urethral sphincter can reduce DWT and improve bladder function in spinal cord injury patients with DSD.

Objective To use the syphilis helicoid gelatin aggregation experiment (TPPA ) method to compare the results of syphilis serological detection reagents between the ELISA method and the colloidal gold method for evaluating the clinical applica ‐bility of each detection reagent .Methods 6 291 serum samples were selected from the hospitalized patients before surgery or before blood transfusion ,and performed the preliminary screening detection by the ELISA method (reagent A and B) and the colloidal gold method ,the positive or weakly positive specimens in preliminary screening were performed the confirmation test by the TPPA method .Results In 6 291 serum specimens ,the positive cases of the reagent A ,reagent B and colloidal gold method were 66 ,64 and 56 cases respectively ,the positive detection rate of colloidal gold method had no obvious difference between the reagent A and rea ‐gent B (P> 0 .05) .The positive samples were confirmed to be 66 cases by TPPA ,including 61 cases of reagent A and reagent B positive ,and the colloidal gold method had 56 cases .5 cases of reagent A positive and 3 cases of reagent B positive were confirmed to be 3 and 2 cases by TPPA respectively ,the sensitivity of the colloidal gold method had significant difference between the reagent A and reagent B(P< 0 .05) .Conclusion ELISA method has high sensitivity and is easy to realize the automated enzyme‐linked im‐munoassay ,which is suitable for the screening of the patient sample before surgery or before blood transfusion .The colloidal gold method has low sensitivity ,but high specificity ,is simple and convenient which is suitable for large‐scale healthy physical examina‐tion and preliminary screening test before emergency surgery .In order to avoid medical disputes ,the positive samples by the ELISA method and colloidal gold method should be confirmed by the TPPA method .

Objective To investigate the eyelid and orbital development of congenital microphthalmia. Design Prospective case se- ties. Participants 23 eyes of 23 patients with congenital microphthalmia aged from 6 months to 78 months. Methods The parameters of palpebral fissure length (PFL), palpebral fissure height(PFH) were measured in all patients. Also, combining the computer tomography (CT) imaging with the computer-aided design system, the anteroposterior axis of eyeball and orbital volumn were calculated automatically. To e- valuate the influence factor of eyelid and orbital growth, correlations between age, anteroposterior axis of eyeball and PFL, PFH, orbital volumn were analyzed. Main Outcome Measures PFL, PFH, anteroposterior axis of eyeball and orbital volumn. Results The PFL, PFH, anteroposterior axis of eyeball and orbital volumn in micro-side were (16.44?3.24) mm, (2.47?1.48) mm, (11.99?3.33) mm, (14.19?2.37) ml respectively. These parameters above were all significantly smaller than the unaffected side (all P=0.000). Moreover, orbital volume showed a strong linear correlation with the anteroposterior axis of eyeball and age(r=0.62, 0.63;p=0.037, 0.035). Both PFL and PFH were corelated with the anteroposterior axis of eyeball (r=0.54, 0.53; P=0.030,0.034), while showing no significant difference with age. According to the an- teroposterior axis of eyeball, two groups, including group less than or equal to 12 mm (10 cases) and group more than 12 mm (13cases), whose PFL,PFH and orbital volumn were (13.50?1.97) mm, (1.08?0.66) mm; (12.73?0.95) ml, (18.20?2.49) mm; (3.30?1.16) mm, (15.05?2.57) ml, respectively. They had statistically significant difference in PFL, PFH and orbital volumn (P=0.001, 0.003,0.024). Conclusion The development of eyelid and orbit with congenital microphthalmia is obviously retarded. The smaller the eyeball is, the much worse in- fluence in eyelid and orbital growth is. The intervention therapy in early stage as far as possible is fundamental approach in simulating the eyelid and orbital development, or preventing and reducing the incidence of orbital deformity.

Background and purpose:Bone metastases leads to the destruction of bones by changing the level of bone turnover markers.The purpose of this study was to assess the clinical application value of bone turnover markers in bone metastases for non-small cell lung cancer,which included the diagnosis and spread behavior of bone metastases.Methods:AKP,β-CTx,OST and BALP were measured in 76 NSCLC with bone metastases patients and 44 normal people.Results:The level ofAKP,β-CTx and BALP in patients with bone metastasis was significantly higher than in the subjects without bone metastases.There were significant correlations among the bone turnover markers.The levels of BALP and OST were significantly positively correlated with the extent of bone metastasis.Patients with high-levels of CTx and low-levels of BALP had a higher risk of pathologic fracture.Conclusion:In patients with bone metastases from NSCLC,bone turnover markers can help make diagnoses and evaluate severity of disease.It potentially has a wide range of uses in clinical practice.

Background and purpose: p21-activated kinase 5 (PAK5) is a recently identified member of PAKs that regulate many intracellular processes such as cytoskeleton remodeling, cell proliferation, cell differentiation, gene transcription and cell apoptosis. Recently, studies found that PAK5 was overexpressed in some cancer such as gastric and colon cancer. However, the expression status and biological function of PAK5 in osteosarcoma are not clearly known. The objective of this study was to investigate the expression of PAK5 in osteosarcoma tissue and their relationships with the prognosis of osteosarcoma. Methods: The expression of PAK5 was detected by using immunohistochemical method in 92 specimens of human osteosarcoma tissues and 33 cases of osteoclastoma tissue, respectively. Results: The positive rate of PAK5 was 71.7% (66/92) in all the 92 cases of osteosarcoma. PAK5 expressions were not related to clinical variables such as gender, age, tumor location, tumor size, histological type and local recurrence, but signiifcantly related to Enneking grade, tumor cell necrosis rate and lung metastasis, and the high expression of PAK5 may reduce the efifciency of chemotherapy. Survival analysis indicated that high expression of PAK5 correlated with poor prognosis of patients with osteosarcoma. Univariate survival analysis showed that the signiifcant prognostic factors were tumor size, Enneking grade, local recurrence, lung metastasis and expression levels of PAK5. COX multivariate regression identified that the PAK5 expression levels (P=0.001) and lung metastasis (P=0.015) were independent prognostic factors of patients with osteosarcoma. Conclusion:The positive expressions of PAK5 closely correlate with Enneking grade, tumor cell necrosis rate and lung metastasis. Detection of PAK5 may be used as a molecular marker for prognosis of osteosarcoma. The high expression of PAK5 may reduce the efifciency of chemotherapy.

We summarized the epidemiological investigation results of the first case of human infection with avian influenza A(H9N2) virus in Chengdu,China,in order to provide references for dealing with similar diseases scientifically in the future.The methods of field epidemiology and laboratory testing were used to collect the H9N2 case's clinical and epidemiological data,as well as collect and test the samples of the H9N2 case and the relevant environment,so that the possible sources of infection,the epidemiological characteristics and clinical features could be analyzed.Results showed that the H9N2 case contacted with poultry within 10 days before the onset of illness and the H9N2 virus nucleic acid was detected in the patient's specimen by PCR.This case suffered from several chronic diseases for a long time,although active treatments were taken this time,she died soon after onset.Her living environment,the chicken leftovers from cooking,and surrounding poultry markets were polluted by H9 avian influenza virus.Through the investigation,we could deduce that the infection source of this case was the chicken infecting H9N2 viruses from surrounding poultry markets.This would be the first fatality associated with influenza A (H9N2) virus infections in humans.And though avian influenza A(H9N2) virus was low pathogenic,infection could cause severe symptoms or death in people with severe underlying diseases.