OBJECTIVE To optimize the salt-processing technology for Anemarrhena asphodeloides. METHODS Taking soaking time， stir-frying temperature， and stir-frying time as factors， Box-Behnken response surface methodology was employed to optimize the salt-processing technology of A. asphodeloides using the contents of mangiferin， neomangiferin， isomangiferin， timosaponin BⅡ， timosaponin AⅢ， timosaponin BⅢ， total flavonoids， and total saponins as evaluation indicators. The entropy weight method was applied to determine the weight of each indicator and calculate the comprehensive score. Based on the 17 sets of Box-Behnken response surface methodology results， a genetic algorithm （GA）-back propagation （BP） neural network was used to further optimize the salt-processing technology， with soaking time， stir-frying temperature， and stir-frying time as input layers and the comprehensive score as the output layer. The salt-processing parameters obtained from the two methods were validated and compared to determine the optimal salt-processing technology for A. asphodeloides. RESULTS The optimal salt-processing conditions obtained via the Box-Behnken response surface methodology were as follows： soaking time of 23 min， stir-frying temperature of 160 ℃ ， and stir-frying time of 12 min， yielding a comprehensive score of 63.370 2. The GA-BP neural network optimization resulted in the following conditions： soaking time of 24 min， stir-frying temperature of 163 ℃， and stir-frying time of 12 min， with a comprehensive score of 65.163 8. The GA-BP neural network optimization outperformed the results obtained by Box-Behnken response surface methodology. CONCLUSIONS This study successfully optimized the salt-processing technology for A. asphodeloides. Specifically， the technology involves adding 15 mL of 0.1 g/mL saline solution to 50 g of the herbal slices， allowing them to moisten for 24 minutes， and then stir-frying at 163 ℃ for 12 minutes.

Objective:To observe any effect of supplementing rehabilitation training with low-frequency repetitive transcranial magnetic stimulation (rTMS) on the abnormal spine posture of Parkinson′s disease (PD) patients.Methods:A total 40 PD patients with Pisa syndrome (PS) were randomly divided into an observation group and a control group, each of 20. Both groups received conventional drug therapy and rehabilitation training (including myodynamia training and balance function training), while the observation group was additionally provided with low-frequency rTMS of the primary motor cortical area (M1) on the convex side of the scoliosis. Before the treatment and after 2 and 3 weeks, the scoliosis angle was measured, and motor functioning and balance were evaluated using the timed up and go test (TUGT) and the Berg balance scale (BBS). The subjects′ mental state was quantified using the exercise self-efficacy (ESE) scale, and the modified Barthel Index (MBI) was used to quantify their ability in the activities of daily life.Results:After the treatment, significant improvement was observed in the average scoliosis angles, TUGT, BBS, ESE and MBI scores of both groups compared to the pre-treatment levels. In the control group, all of the indicators had returned to their pre-treatment levels 3 weeks after treatment, but in the observation group they remained significantly improved.Conclusions:Low-frequency rTMS combined with rehabilitation training can significantly reduce the scoliosis angle of PD patients, improve their motor functioning and balance, increase their exercise confidence and improve their ability in the activities of daily living over the long term. The combination is worth applying and promoting in clinical practice.

Objective:To observe any effect of combining transcranial magnetic stimulation (rTMS) with aerobic exercise on the cognitive functioning of early stage Parkinson′s disease (PD) patients.Methods:A total of 120 PD patients in the early stage were randomly divided into an observation group and a control group, each of 60. Both groups received conventional drug treatment and moderate-intensity aerobic exercise training, while the observation group was additionally provided with high-frequency rTMS treatment. Before and after 3 months of the treatments, everyone′s cognitive and motor functioning was evaluated using the Montreal Cognitive Assessment Scale (MoCA) and the third part of the Unified Parkinson′s Disease Rating Scale (UPDRS-Ⅲ), respectively. Negative emotions were evaluated using the Hamilton Anxiety Scale (HAMA) and the Hamilton Depression Scale (HAMD). Auditory event-related potentials were also detected, and the latency and amplitude of P300 were analyzed.Results:The average MoCA, UPDRS-Ⅲ, HAMA and HAMD scores, as well as the amplitude and latency of P300 had improved significantly in both groups after the treatment. At that point the observation group′s performance was significantly better than that of the control group in terms of the MoCA′s visuospatial and executive function, attention and delayed recall indicators, and also total score. The observation group′s average HAMA score (10.55±3.11), HAMD score (9.78±4.10), the P300 amplitude [(11.29±2.21)μV] and latency [(384.75±48.26)ms] were also significantly better. The UPDRS-Ⅲ scores were negatively correlated with the visuospatial and executive function scores of the MoCA scale in the observation group before and after treatment, while the average HAMA score was negatively correlated with the attention and delayed recall scores.Conclusions:Supplementing aerobic exercise with rTMS can significantly improve the cognition and motor functioning of early stage PD patients. The combination is more effective than aerobic exercise alone. Such combined therapy is worthy of popularization and clinical application.

Objective:To observe any effect of supplementing rehabilitation training with low-frequency repetitive transcranial magnetic stimulation (rTMS) on the abnormal spine posture of Parkinson′s disease (PD) patients.Methods:A total 40 PD patients with Pisa syndrome (PS) were randomly divided into an observation group and a control group, each of 20. Both groups received conventional drug therapy and rehabilitation training (including myodynamia training and balance function training), while the observation group was additionally provided with low-frequency rTMS of the primary motor cortical area (M1) on the convex side of the scoliosis. Before the treatment and after 2 and 3 weeks, the scoliosis angle was measured, and motor functioning and balance were evaluated using the timed up and go test (TUGT) and the Berg balance scale (BBS). The subjects′ mental state was quantified using the exercise self-efficacy (ESE) scale, and the modified Barthel Index (MBI) was used to quantify their ability in the activities of daily life.Results:After the treatment, significant improvement was observed in the average scoliosis angles, TUGT, BBS, ESE and MBI scores of both groups compared to the pre-treatment levels. In the control group, all of the indicators had returned to their pre-treatment levels 3 weeks after treatment, but in the observation group they remained significantly improved.Conclusions:Low-frequency rTMS combined with rehabilitation training can significantly reduce the scoliosis angle of PD patients, improve their motor functioning and balance, increase their exercise confidence and improve their ability in the activities of daily living over the long term. The combination is worth applying and promoting in clinical practice.

Objective:To observe any effect of combining transcranial magnetic stimulation (rTMS) with aerobic exercise on the cognitive functioning of early stage Parkinson′s disease (PD) patients.Methods:A total of 120 PD patients in the early stage were randomly divided into an observation group and a control group, each of 60. Both groups received conventional drug treatment and moderate-intensity aerobic exercise training, while the observation group was additionally provided with high-frequency rTMS treatment. Before and after 3 months of the treatments, everyone′s cognitive and motor functioning was evaluated using the Montreal Cognitive Assessment Scale (MoCA) and the third part of the Unified Parkinson′s Disease Rating Scale (UPDRS-Ⅲ), respectively. Negative emotions were evaluated using the Hamilton Anxiety Scale (HAMA) and the Hamilton Depression Scale (HAMD). Auditory event-related potentials were also detected, and the latency and amplitude of P300 were analyzed.Results:The average MoCA, UPDRS-Ⅲ, HAMA and HAMD scores, as well as the amplitude and latency of P300 had improved significantly in both groups after the treatment. At that point the observation group′s performance was significantly better than that of the control group in terms of the MoCA′s visuospatial and executive function, attention and delayed recall indicators, and also total score. The observation group′s average HAMA score (10.55±3.11), HAMD score (9.78±4.10), the P300 amplitude [(11.29±2.21)μV] and latency [(384.75±48.26)ms] were also significantly better. The UPDRS-Ⅲ scores were negatively correlated with the visuospatial and executive function scores of the MoCA scale in the observation group before and after treatment, while the average HAMA score was negatively correlated with the attention and delayed recall scores.Conclusions:Supplementing aerobic exercise with rTMS can significantly improve the cognition and motor functioning of early stage PD patients. The combination is more effective than aerobic exercise alone. Such combined therapy is worthy of popularization and clinical application.

Objective:To observe any therapeutic effect of combining botulinum toxin type A (BTX-A) with rehabilitation training in treating Parkinson′s disease (PD) patients with striatal foot deformity (SFD).Methods:A total of 68 PD patients with SFD were randomly divided into a control group and a treatment group. Both groups were given routine medication with pramipexole and dopamine receptor agonists and received lower limb rehabilitation training, including passive activity training, strength training and walking training. The treatment group was additionally injected with BTX-A. Sciatic pain was quantified using a visual analogue scale. The Unified Parkinson′s Disease Rating Scale-lower limb motor lower limb motor function (UPDRS-LLM) scale, the Berg balance scale and the modified Barthel index were applied to test all of the participants before the experiment and on the 7th, 14th and 30th day of the treatment.Results:The average scores of the control group on all of measures at were significantly better than those of the control group at the same time points, and by the 14th and 30th day had improved significantly compared with those before treatment.Conclusion:Supplementing rehabilitation training with BTX-A can significantly improve foot deformity and relieve the muscle tension and spastic pain of PD patients with SFD, promoting the motor functioning of their lower limbs, their balance and their performance in the activities of daily living.

Objective:To explore any effect of supplementing low-frequency repeated transcranial magnetic stimulation (rTMS) with intermittent resistance training on muscle tone and the recovery of motor function among persons with Parkinson′s disease (PD).Methods:A total of 104 PD patients were randomly divided into an observation group and a control group, each of 52. Both groups were treated with conventional drugs and low-frequency rTMS, while the observation group was additionally provided with intermittent resistance training for 8 weeks. Before and after the intervention, the motor functioning of both groups was evaluated using unified Parkinson′s disease rating scale-III (UPDRS-III) and the Berg Balance Scale (BBS). Limb muscle tension was quantified using the modified Ashworth scale (MAS). The subjects′ psychological states were quantified using the exercise self-efficacy scale (ESE), and the modified Barthel index (MBI) was applied to evaluate their ability in the activities of daily living. A 3D motion processing system collected and analyzed data describing each subject′s gait kinematics.Results:After the intervention, significantly greater average improvement was observed in all of the outcome measures among the observation group compared with the control group.Conclusion:Combining intermittent resistance training with low-frequency rTMS can significantly reduce muscle tone and improve the motor functioning of PD patients. The combination is more effective than low-frequency rTMS alone.

Objective To investigate the diagnostic value of cervical vagus nerve cross-sectional area(CAS)for Parkinson's disease(PD).Methods Thirty patients with PD admitted to the People's Hospital of Zhengzhou University from October 2019 to October 2022 were selected as PD group,25 patients with multiple system atrophy(MSA)admitted to the People's Hospital of Zhengzhou University during the same period were selected as the MSA group,and 30 healthy individuals who underwent physical examination in the People's Hospital of Zhengzhou University during the same period were selected as healthy control group.Cervical vagus CAS of subjects in the three groups were measured by high-resolution ultrasound,and the difference of CAS of cervical vagus nerve was compared among the three groups.The degree of impairment of autonomic nervous function of subjects in the three groups was evaluated by PD autonomic symptom scale(SCOPA-AUT).The diagnostic value of cervical vagus nerve CAS for PD was analyzed by receiver operating characteristic(ROC)curve.Results The CAS of the right cervical vagus nerve of subjects was significantly larger than that of the left in the healthy control group and PD group(P＜0.05);there was no significant difference in CAS of bilateral cervical vagus nerve of subjects in the MSA group(P＞0.05).The CAS and average CAS of bilateral cervical vagus nerve of subjects in the PD group and MSA group were significantly lower than those in the healthy control group(P＜0.01).The CAS of the right vagus nerve of subjects in the MSA group was significantly lower than that in the PD group(P＜0.05);there was no significant difference in CAS and the average CAS of the left vagus nerve between the MSA group and the PD group(P＞0.05).The total score of SCOPA-AUT and gastrointestinal(GI),cardiovascular(CV),urinary(UR)and sexual(SX)scores of subjects in the PD group and MSA group were significantly higher than those in the healthy control group(P＜0.01).The total score of SCOPA-AUT and UR,SX scores of subjects in the MSA group were significantly higher than those in the PD group(P＜0.05).There was no significant difference in temperature(TH)and pupil(PU)of subjects among the three groups(P＞0.05).Pearson correlation analysis showed that the CAS of cervical vagus nerve of PD patients was not correlated with the total score of SCOPA-AUT and the UR,TH,PU,SX scores(r=-0.143,0.281,0.297,0.265,0.312;P＞0.05).The CAS of cervical vagus nerve of PD patients was negatively correlated with GI and CV scores(r=-0.683,-0.373;P＜0.05).ROC curve analysis showed that the area under the curve of cervical vagus nerve for diagnosing PD was 0.870(95％confidence interval:0.773-0.966,P＜0.05);the critical value was 3.064 mm2,the sensitivity was 96％,and the specificity was 67％.The area under the curve of CAS of cervical vagus nerve in differential diagnosis of PD,MSA was 0.680(95％confidence interval:0.537-0.823,P＜0.05).The sensitivity and specificity for the diagnosis of MSA were 68％and 70％when the CAS of the cervical vagus nerve＜2.709 mm2.Conclusion The CAS of cervical vagal nerve has high clinical diagnostic value for PD,and it provides a new way to improve the diagnosis rate of PD.

Background::Familial hypercholesterolemia (FH) is underrecognized, and its association with coronary artery disease (CAD) remains limited, especially in China. We aimed to investigate the prevalence of FH and its relationship with CAD in a large Chinese cohort.Methods::FH was defined using the Make Early Diagnosis to Prevent Early Death (MEDPED) criteria. The crude and age-sex standardized prevalence of FH were calculated based on surveys of the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project during 2007-2008. The associations of FH with incident CAD and its major subtypes were estimated with the cohort-stratified multivariate Cox proportional hazard models based on the data from the baseline to the last follow-up (2018-2020).Results::Among 98,885 included participants, 190 participants were defined as FH. Crude and age-sex standardized prevalence and 95% confidence interval (CI) of FH were 0.19% (0.17%–0.22%) and 0.13% (0.10%–0.16%), respectively. The prevalence varied across age groups and peaked in the group of 60–<70 years (0.28%), and the peak prevalence (0.18%) in males was earlier, yet lower than the peak crude prevalence in females (0.41%). During a mean follow-up of 10.7 years, 2493 cases of incident CAD were identified. After multivariate adjustment, FH patients had a 2.03-fold greater risk of developing CAD compared to non-FH participants.Conclusions::The prevalence of FH was estimated to be 0.19% in the participants, and it was associated with an elevated risk of incident CAD. Our study suggests that early screening of FH has certain public health significance for the prevention of CAD.

Background::Familial hypercholesterolemia (FH) is underrecognized, and its association with coronary artery disease (CAD) remains limited, especially in China. We aimed to investigate the prevalence of FH and its relationship with CAD in a large Chinese cohort.Methods::FH was defined using the Make Early Diagnosis to Prevent Early Death (MEDPED) criteria. The crude and age-sex standardized prevalence of FH were calculated based on surveys of the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project during 2007-2008. The associations of FH with incident CAD and its major subtypes were estimated with the cohort-stratified multivariate Cox proportional hazard models based on the data from the baseline to the last follow-up (2018-2020).Results::Among 98,885 included participants, 190 participants were defined as FH. Crude and age-sex standardized prevalence and 95% confidence interval (CI) of FH were 0.19% (0.17%–0.22%) and 0.13% (0.10%–0.16%), respectively. The prevalence varied across age groups and peaked in the group of 60–<70 years (0.28%), and the peak prevalence (0.18%) in males was earlier, yet lower than the peak crude prevalence in females (0.41%). During a mean follow-up of 10.7 years, 2493 cases of incident CAD were identified. After multivariate adjustment, FH patients had a 2.03-fold greater risk of developing CAD compared to non-FH participants.Conclusions::The prevalence of FH was estimated to be 0.19% in the participants, and it was associated with an elevated risk of incident CAD. Our study suggests that early screening of FH has certain public health significance for the prevention of CAD.