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Background@#and Purpose Orthostatic hypotension (OH) is common in patients with Parkinson’s disease (PD). Early recognition OH is required with sensitive assessments. The purpose of this study was to determine whether blood pressure (BP) changes during exercise can predict the occurrence of OH in PD. @*Methods@#This prospective cohort study included 80 consecutive patients with PD. All patients agreed to participate in a baseline evaluation and cardiopulmonary exercise test (CPET).According to the initial active standing test (AST), those without OH (PD-nonOH) at baseline had their AST results followed up for 6 months. The main outcome was defined as whether patients without OH at baseline would develop OH after 6 months. Logistic regression analysis was applied to identify the relevant variables. A nomogram was constructed based on clinical features and identified variables. The concordance index (C-index) and area under the receiver operating characteristic curve (AUC) were used to evaluate the accuracy and predictive ability of the nomogram, respectively. @*Results@#CPET results indicated that peak load, peak heart rate, heart rate recovery at 1 min, and systolic BP change (ΔSBP) were lower in those with OH than in the PD-nonOH group (p<0.05) at baseline. Logistic regression analysis indicated that peak load and ΔSBP during CPET had significant effects on OH (p<0.05). Age, sex, peak load, and ΔSBP were used to construct the nomogram model (C-index=0.761). The prediction model had an AUC of 0.782 (95% confidence interval=0.649–0.889) and a specificity and sensitivity of 70.0% and 81.8%, respectively. @*Conclusions@#This study has identified predictive factors for OH development in patients with PD. CPET could be used as a complementary examination to identify patients at a high risk of OH.
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This paper introduced European Guidelines for Physiotherapy of Parkinson's Disease, especially the form, content and selection, to give a reference of evidence-based practice in China.
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Rehabilitation is increasingly valued in the field of Parkinson's disease (PD) therapy. European countries issued European Physiotherapy Guideline for Parkinson's Disease in 2014. Based on the analysis of the evaluation method in the guideline, combined with the recent literature and clinical feasibility, this paper mainly analyzed the evaluation tools recommended by the European guidelines for physical therapy of PD, the general requirements for using the recommended evaluation tools and the significance of evaluation, in terms of pre-evaluation tools, evaluation tools to assess the effectiveness of physical therapy, evaluation tools to assess the severity and progression of PD and the evaluation of cognitive psychology.
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AIM:To enhance the doctors` ability of disease diagnosis and treatment by using standardized patients in neuro-ophthalmology teaching.METHODS: Graduated students and visiting students accepting neuro-ophthalmology training courses in Department of Ophthalmology during 2014-2016 were enrolled as the research objects.Two groups were randomized allocated and 20 students each group.One group of students was applied standardized patients teaching method and the other group of students was applied traditional teaching method.A questionnaire and exam after the teaching were evaluated.The data were analyzed by SPSS 20.0.RESULTS: The data of questionnaire included content interest improving,satisfaction for teaching,the key points understanding,theory with practice effective linking,future practice instruction.Comparison questionnaire data between two groups were of statistical significance (P<0.05).The test scores of case analysis of two groups were statistically significant also(P<0.001).CONCLUSION: Standardized patients teaching method is helpful for students` training on the ability of clinical diagnosis and treatment.
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<p><b>BACKGROUND</b>Two novel presenilin 1 (PS1) mutations, V97L and A136G, were recently found to be involved in the early-onset of Alzheimer's disease in two Chinese families. This research aimed to verify their pathological effects.</p><p><b>METHODS</b>The human neuroblastoma SH-SY5Y cells stably transfected with these two Chinese presenilin 1 mutations were established to explore whether they are sensitive to, or influenced by, serum deprivation and protected by insulin-like growth factor-1 (IGF-1). Apoptosis rate, glucose uptake of the cells and the expression of glucose transport protein 1 (GLUT1) on cell membranes were examined.</p><p><b>RESULTS</b>The V97L or A136G mutants significantly decreased the cells viability and increased the apoptosis rate when compare to PS1wt and mock transfected cells. IGF-1 was found to improve the viability of these two kinds of mutant cells significantly, and to show a protective effect for the mutants when they were treated with trophic deprivation. The glucose uptake of each transfected cell line increased to about 25% after IGF-1 treatment, GLUT1 expression on the cell membrane increased modestly by about 15% - 20%.</p><p><b>CONCLUSIONS</b>Enhanced sensitivity to trophic withdrawal in the cells transfected with the two Chinese PS1 mutations may contribute to the neuron apoptosis. IGF-1 provided a protective effect to cells, possibly through an enhanced glucose transport and mitochondrial activities.</p>