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Objective To analyze the clinical features, laboratory findings, electroencephalography (EEG) and neuroimaging of the neurosyphilis presented with parkinsonism as the principal manifestation to improve the diagnosis of neurosyphilis. Methods Eight eurosyphilis patients were from department of neurology of Hainan provincial people’s hospital from early July 2010 to December 2014. We retrospectively analyzed the clinical manifestation, laboratory exami?nations, neuroimaging examinations, diagnosis and treatment outcomes of 8 cases neurosyphilis who presented with par?kinsonism as principal manifestation. Results Myotonia and bradykinesia were principal symptoms in these 8 cases. Limb tremor, posture disorder, abnormal mental behavior and cognitive impairment occurred in some patients. Serum treponema pallidum particle agglutination (TPPA) and toluidine red untreated serum test (TRUST)were positive in 8 cas?es. Cerebrospinal fluid (CSF) protein and cell counts were elevated in all the patients. CSF-TPPA and TRUST were posi?tive in all the patients. The MRI showed that cerebral infarction in basal ganglia, cerebral atrophy in temporal lobe and hippocampus and ventricular enlargement in all the patients. EEG showed abnormal activity in all the patients. After treatment with a large dose of penicillin, clinical symptoms were obviously improved;the titer of serum and CSF TRUST decreased;and scores of UPDRS decreased in all the patients. Conclusions There is a wide variation in the clinical man?ifestation of the neurosyphilis. When patients present with Parkinsonism, we should comprehensively analyze the laborato?ry examinations, EEG and neuroimaging to rule out the possibility of neurosyphilis.
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Objective To observe neurophysiological changes and pulmonary function in obstructive sleep apnea syndrome (OSAS) and analyze their inter-relationship. Methods Sixty OSAS patients were studied. Their lung function and phrenic motor nerve conduction (PNC) were examined. Thirty cases without respiratory disorder served as controls. The lung function tests included percentage of the predicted value of vital capacity ( VC% ), percentage of the predicted value of maximal voluntary ventilation ( MVV% ), percentage of the predicted value of forced expiratory volume in one second ( FEV1% ), inspiratory capacity ( IC), and expiratory reserve volume (ERV). The phrenic nerve was stimulated electrically, and the latent period and the diaphragmatic compound muscle action potential (dCMAP) were recorded. Results The VC%, MVV%, FEV1% , IC and ERV of the patients with OSAS were significantly lower than those of the controls. There was no significant difference between the patients and the controls with regard to their PNC latency. In the OSAS patients the amplitude ratio of their dCMAPs was positively correlated with VC% , MVV% , FEV1% , IC and ERV, and negatively with an apnea hypopnea index (AHI).Conclusions PNC examination can provide valuable information for evaluating diaphragmatic dysfunction in those with abnormal lung function. Decreased dCMAP might be associated with abnormal lung function.
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Objective To explore the relationship between uric acid (UA) level and cognitive function in elderly patients with Parkinson,s disease (PD) and analyze the cognition related factors.Methods The clinical data of 60 elderly PD cases in our hospital from 2001 to 2009 were retrospectively analyzed. The 60 healthy people receiving medical examination in our hospital and matched by gender and age, were as control group. The information including gender, age, illness duration, Hoehn & Yahr stage (H-Y stage), serum UA level and Mini-Mental State Examination (MMSE) scale were recorded. Results The serum UA level was significantly lower in PD group than in control group [(262±53) μmol/L vs. (332±45) μmol/L, t=-6.724, P＜0.001]. In PD group, the serum UA level was slightly higher in males than in females [(271 ±48) μmol/L vs.(254±39) μmol/L, t=3. 282, P=0. 058]. The serum UA level was significantly lower in male PD patients than in male controls [(353± 62) μmol/L, t=- 5. 625, P＜0. 001], and was lower in female PD patients than in female controls [( 294 ± 59) μmol/L, t = - 4. 721, P = 0. 012]. There were no significant differences in serum UA level among different H-Y stage subgroups (P＞0. 05), but the serum UA level was lower in different H-Y stage subgroups than in control group (F=22. 039, P＜0. 01 ). There was no correlation between the UA level and the illness duration (r=0. 961, P＞0.05).The MMSE score had significant difference between elderly PD group and control group (t= -3. 168,P＜0. 001). In PD patients, the MMSE score was positively correlated with serum UA level (r=0. 789, P= 0. 000), and was negatively correlated with H-Y stage (r= - 0. 577, P = 0. 019 ), age (r= -0. 333, P=0. 034), but was not correlated with illness duration (r= -0. 333, P=0. 207) and BMI (t=- 0. 410, P= 0. 115). Conclusions The level of serum UA is lower in elderly patients with PD than in normal controls. There is correlation between the serum UA level and cognitive impairment. Lower serum UA level predicts worse cognitive scores.
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Objective:To study the relationship between the single nucleotide polymorphisms (SNP)936C/T,-460T/C,405G/C in Vascular endothelial growth factor (VEGF)gene and their association with cerebral infarction (CI).Methods:Case-control study was carried out to investigate allelic genotypes and frequency of the three VEGF SNP in 150 subjects with CI and 120 control individuals.Polymerase chain reaction-Restriction fragment lengthpolymorphism,(PCR-RFLP)[U3] and DNA sequencing were used to analyze the polymorphisms.The correlations between VEGF SNPs and CI were evaluated.Results:There was a highly significant difference in allele frequency of 936C/T SNP between CI and control subjects,and the T allele frequencies were respectively 0.3667 versus 0.2500(P