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Objective Recent data have shown that regular exercise may ameliorate motor symptoms in Parkinson’s disease (PD). This study aims to investigate how intended exercise impacts motor and non-movement symptoms of PD. Methods 88 patients were randomly assigned to an early exercise group (E-EG), late exercise group (L-EG), or a control group (CG) using a randomized delayed-start design. The E-EG carried out a rigorous, formal exercise program for one hour, twice per week, for 18 months (May 2018 - November 2019). The L-EG took part in the exercise program in the final 6–12 months of the study. We assessed outcomes using the Unified Parkinson’s Disease Rating Scale (UPDRS), PDQ-39 Questionnaire, Line A test, Line B test, Nine-hole column test, 30 seconds squat and stand-up test (30s SST), 10m Walk test(10mW), Balance Evaluation Systems Mini Test (MiniBESTest), FAB and Time Up and Go Test(TUG). Results The patients with PD in the E-EG had lower performance in the UPDRS and Line B test compared to those in the L-EG at post-exercise(p

Nemaline myopathy (NM) is a congenital myopathy of great heterogeneity, characterized by the presence of rods in the cytoplasm of muscle fibers. The samples of 16 nemaline myopathy patients diagnosed by characteristically pathological features went through whole exon sequencing. Clinico-pathological and genetic features of the cases were systematically analyzed. According to the classification of nemaline myopathy by ENMC, 8 cases are typical congenital subtype, 6 cases are childhood/juvenile onset subtype and 2 case are adult onset subtype. In histological findings, characteristic purple-colored rods are discovered under modified gömöri trichrome staining (MGT). Electron microscopy revealed the presence of high electron-dense nemaline bodies around the submucosa and the nucleus nine patients (9/16 56.3%) were detected pathogenic causative mutations, among whom mutations in the NEB gene were the most frequent (6 patients, 66.7%). KBTBD13 gene mutation was discovered in two patients and ACTA1 gene mutation was discovered in 1 patient. Nemaline myopathy is a congenital myopathy with highly clinico-pathological and genetic heterogeneity. NEB gene mutation is the most common mutation, in which splicing change c.21522 +3A > G is hotspot mutation in Chinese NM patients.

As an autoimmune central nervous system disease characterized by inflammation and demyelination, neuromyelitis optica (NMO) has been extensively investigated. A specific antigenic target, astrocytic water channel aquaporin-4 (AQP4) has already been identified, and it can be recognized explicitly by the autoantibody marker NMO-IgG. Along with the immune attacks, clinical disabilities would gradually accumulate. As there has been no validated and well-recognized therapy for NMO till now, preventing and postponing attack using immunosuppressive therapies is the primary treatment option. In the current retrospective study, the effect of immunosuppressive agents was investigated through a long-term follow-up. To assess the long-term effectiveness and safety of rituximab (RTX), azathioprine (AZA), and mycophenolate mofetil (MMF) therapies, all 129 patients with NMO spectrum disorders (NMOSD) who received at least one of these treatments were studied, including 55 seropositive for AQP4-Ab and 74 seronegative for AQP4-Ab. The median post-treatment annualized relapse rate (ARR) was lower than the pre-treatment rates in all AQP4+Ab groups (from 1.0 to 0.7 in RTX, from 0.8 to 0.3 in AZA, and from 0.85 to 0.35 in MMF). Meanwhile, the ARR also decreased in all AQP4−Ab groups (from 0.3 to 0.2 in RTX, from 0.9 to 0.5 in AZA, and from 0.9 to 0.4 in MMF). Disability condition improved in the Expanded Disability Status Scale (EDSS) in all AQP4+Ab groups (from 4.0 to 2.75 in RTX, from 3.5 to 2.5 in AZA, and from 3.0 to 2.0 in MMF) and in all AQP4−Ab groups (from 3.0 to 2.5 in RTX, from 3.0 to 2.5 in AZA, and from 3.5 to 2.0 in MMF). There was no statistically significant difference between the post-treatment and pre-treatment changes of EDSS and ARR in the RTX, AZA, and MMF groups (P > 0.05). However, according to Kaplan–Meier survival analysis, RTX-treated patients were more likely to be relapse-free after long-term follow-up than those who received AZA or MMF therapy. Meanwhile, adverse effects were noted in three out of 23 patients with RTX treatment, five of 32 with AZA treatment, and three of 21 with MMF treatment. No serious adverse events were observed in all treatment groups during the study. RTX, AZA, and MMF therapies efficiently lowered the relapse frequency and disability in both of the AQP4-Ab seropositive or seronegative patients with NMO. Furthermore, low dosage of RTX is recommended for the patients with NMO owing to its long-term effectiveness and safety.

We report on the development of a 940-nm diode laser bar based on epitaxially stacked active regions by employing a tunnel junction structure. The tunnel junction and the device parameters were systematically optimized to achieve high output and power conversion efficiency. A record quasi-continuous wave (QCW) peak power of 1.91 kW at 25 °C was demonstrated from a 1-cm wide bar with a 2-mm cavity length at 1 kA drive current (200 μs pulse width and 10 Hz repetition rate). Below the onset of the thermal rollover, the slope efficiency was as high as 2.23 W/A. The maximum power conversion efficiency of 61.1% at 25 °C was measured at 300 A. Reducing the heatsink temperature to 15 °C led to a marginal increase in the peak power to 1.95 kW.

Anti-Sry-like high mobility group box (SOX) 1 antibodies (abs) are partly characterized onconeural autoantibodies (autoabs) due to their correlation with neoplastic diseases. Anti-SOX1 abs are associated with various clinical manifestations, including Lambert-Eaton myasthenic syndrome (LEMS) and paraneoplastic cerebellar degeneration (PCD). However, the clinical characteristics of patients with anti-SOX1 abs have not been described in detail. This review systematically explores the reported patients with anti-SOX1 abs and analyzes these cases for demographic characteristics, clinical features, coexisting neuronal autoabs, neuroimaging findings, treatment, and clinical outcomes. In addition, considering that PCD is the most common paraneoplastic neurological syndrome and that the association between PCD and anti-SOX1 abs remains unclear, we focus on the presence of autoabs in relation to PCD and associated tumors. PCD-associated autoabs include various intracellular autoabs (e.g., anti-Hu, anti-Yo, anti-Ri, and anti-SOX1) and cell-surface autoabs (anti-P/Q-type voltage-gated calcium channel). Commonly involved tumors in PCD are small-cell lung cancer (SCLC), gynecological, and breast tumors. LEMS is the most common clinical symptom in patients with anti-SOX1 abs, followed by PCD, and multiple neuronal autoabs coexist in 47.1% of these patients. SCLC is still the predominant tumor in patients with anti-SOX1 abs, while non-SCLC is uncommon. No consistent imaging feature is found in patients with anti-SOX1 abs, and there is no consensus on either the therapy choice or therapeutic efficacy. In conclusion, the presence of anti-SOX1 abs alone is a potential predictor of an uncommon paraneoplastic neurological disorder, usually occurring in the setting of LEMS, PCD, and SCLC. The detection of anti-SOX1 abs contributes to an early diagnosis of underlying tumors, given the diversity of clinical symptoms and the absence of characteristic neuroimaging features.

Objective Dementia with Lewy bodies (DLB) is a common type of neurodegenerative dementia. Molecular neuroimaging using dopamine transporter (DaT), Pittsburgh compound B (PIB), and fluorodeoxyglucose (FDG) positron emission tomography (PET) has advantages in detecting dopaminergic neuron loss, abnormal amyloid β-protein deposition, and glucose metabolism changes in patients with neurodegenerative disorders. However, the multi-modality molecular imaging features of patients with DLB have rarely been reported. Methods Five patients with a probable diagnosis of DLB were enrolled. PET/magnetic resonance imaging was performed with three tracers: 11C-β-CFT, 11C-PIB, and 18F-FDG. Clinical and imaging characteristics were analyzed. Results All patients with DLB showed reduced uptake in the bilateral putamen on DaT PET, increased uptake throughout the cerebral cortex on PIB PET, and intact metabolism of the posterior cingulate gyrus on FDG PET. Conclusion Multimodal molecular imaging is helpful for early diagnosis of DLB. Studies with larger sample sizes are needed to confirm the molecular imaging differences between DLB and Alzheimer’s disease and Parkinson’s disease dementia.

The continuous-wave 100 W-class 808 nm laser diode arrays with extremely high power conversion efficiency of 68% were reported at the heatsink temperature of 25 °C. To the best of our knowledge, this was the highest power conversion efficiency at continuous-wave 106 W 808 nm laser diode array with 50% fill factor so far. An asymmetric broad waveguide epitaxial structure with very low internal optical loss of 0.5 cm −1 was presented. In order to improve the efficiency, various fill factor devices were studied. The 50 W laser diode array with 30% fill factoir and 1.0 mm cavity length demonstrated power conversion efficiency of 71% at heatsink temperature of 15 °C.

Semiconductor lasers with high power conversion efficiency (PCE) and output power are heavily investigated driven by more energy-efficient commercial applications. In this paper, an asymmetric broad area laser (A-BAL) design is studied and compared with a conventional symmetric broad area laser (S-BAL) design for 808 nm single emitter laser diodes. We present a comparative theoretical and experimental investigation by studying the thermal effects on the laser parameters. The output characteristics and efficiency loss paths for the designs were analyzed. The leakage of carriers was identified as the primary source of the PCE reduction with temperature. Suppressing this leakage by optimization of the A-BAL design, a record continuous-wave PCE of 68% at 25 °C and 60.4% at 75 °C were achieved for a single emitter laser with 10 W output power. These devices deliver high efficiency at high temperatures with reliable operation achieving 2000 h of an accelerated aging lifetime without failures.

Broad-area diode lasers with high output power and low lateral divergence angle are highly desired for extensive scientific and industrial applications. Here, we report on the epitaxial design for higher output power and a flared waveguide design for reduced divergence, which leads to high power operation with a low lateral divergence angle. A vertically asymmetric epitaxial structure was employed and optimized for low internal optical loss and high efficiency to realize high output power operation. Using a flared waveguide design, the lateral divergence angle was efficiently reduced by decreasing the number of high-order lateral optical modes significantly. The flared waveguide design introduces a smooth modification of the ridge width along the cavity without deteriorating laser performance. Based on the optimized epitaxial and waveguide design, we scaled the waveguide width to realize high continuous-wave power of 34.5 W at 25 °C. A low lateral divergence angle of 8° and high power conversion efficiency of 60% were achieved at the operating power level of 25 W. The life test data (30 A at 45 °C for 39 units, 0 failures in 1000 h) demonstrated reliable operation illustrating the efficient design for reduced lateral divergence angle and high operating power.

A novel black phosphorus (BP) solution saturable absorber (SA) is fabricated by the liquid-phase-exfoliated method and successfully used for passively Q-switched (QS) Nd:YVO4 laser. Compared with a traditional solid SA, a BP solution SA possesses more excellent optical transparency and higher damage resistance. The shortest pulse duration and highest average output power are measured to be 119 ns and 1.23 W, respectively. To the best of our knowledge, both of them are the best results among QS solid-state lasers with BP-based absorbers so far. The repetition rate is in the range of 533.2 to 722 kHz. The results indicate the potential application of the BP solution SA into high-power solid-state pulse lasers.

The report presents the high power mode-locking operation in an anomalous-dispersion fiber laser with a novel WS 2 saturable absorber (SA) based on fluorine mica (FM) substrate. Compared to organic host material such as polymer, FM has higher softening temperature, heat dissipation and laser damage threshold. By employing the SA, a stable mode-locked fiber laser is achieved. The duration of the pulse broadens from 2.816 ns to 3.654 ns almost linearly with increasing pump power. The average output power and single pulse energy can increase up to 33.5 mW and 4 nJ at the maximum pump power respectively. The results indicate that WS 2 /FM material is an ideal SA for high power Er-doped fiber (EDF) lasers.

High-power GaAs-based semiconductor lasers are the most efficient source of energy for converting electrical into optical power. 940nm diode lasers are used directly or as pump sources for Yb:YAG solid-state lasers, and are widely used in laser cladding and other fields. Improving electro-optic conversion efficiency and reliable output power are urgent requirements for current research hotspots and industrial laser systems. In this paper, we use an asymmetric epitaxial structure of InGaAs/AlGaAs, which reduces the optical loss and resistance, and adopt better cavity surface technology to present 940nm 1-cm quasi-continuous micro-channel cooling (MCC) laser bars. The lasers are tested under a high duty cycle of 9.6% (600us,160Hz) at 25°C with output power of 660.05W, electro-optic conversion efficiency of 64.71% at 600A and slope efficiency of 1.16 W/A. The peak efficiency reaches 72.4%. The increased efficiency results from a lower threshold current and a lower series resistance. Furthermore, the output power of 1025W (1000A) has been confirmed at a duty cycle of 4% (400us,100Hz).

The wide array of clinical manifestations of dopa-responsive dystonia (DRD) or Segawa disease and the prevalence of numerous DRD-associated mutations in guanosine triphosphate cyclohydrolase 1 (GCH1) gene makeDRD diagnosis challenging. Methods: In this study, we assessed the clinical and genetic characteristics of two Chinese families with 3 DRD probands. Clinical assessment of DRD-related symptoms was conducted for all participants. All 6 exons of GCH1 were assessed by genetic analyses for individuals with heteroduplex DNA as compared that of controls. Results: The median DRD-onset age was 24 years and the female to male ratio of DRD patients was 8:1. Six out of eight (75%) patients responded to levodopa therapy. The data indicated that the GCH1 sequence had a novel point mutation resulting in T to C transition at position 80 in exon 1 of the cDNA sequence (c.80T>C), which resulting in an amino acid change (L27P) of GCH1 in the probands and their mother in the first DRD family. Conclusion: A novel GCH1 mutation (c.80T>C) was identified in the DRD patients in the first family. Our findings indicate that both clinical symptom assessment and genetic testing should be employed for improving DRD diagnosis.

Summary Background Acute kidney injury (AKI) has become a worldwide public health problem, but little information is available about the disease burden in China. We aimed to evaluate the burden of AKI and assess the availability of diagnosis and treatment in China. Methods We launched a nationwide, cross-sectional survey of adult patients who were admitted to hospital in 2013 in academic or local hospitals from 22 provinces in mainland China. Patients with suspected AKI were screened out on the basis of changes in serum creatinine by the Laboratory Information System, and we reviewed medical records for 2 months (January and July) to confirm diagnoses. We assessed rates of AKI according to two identification criteria: the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) AKI definition and an increase or decrease in serum creatinine by 50% during hospital stay (expanded criteria). We estimated national rates with data from the 2013 report by the Chinese National Health and Family Planning Commission and National Bureau of Statistics. Findings Of 2 223 230 patients admitted to the 44 hospitals screened in 2013, 154 950 (7·0%) were suspected of having AKI by electronic screening, of whom 26 086 patients (from 374 286 total admissions) were reviewed with medical records to confirm the diagnosis of AKI. The detection rate of AKI was 0·99% (3687 of 374 286) by KDIGO criteria and 2·03% (7604 of 374 286) by expanded criteria, from which we estimate that 1·4–2·9 million people with AKI were admitted to hospital in China in 2013. The non-recognition rate of AKI was 74·2% (5608 of 7555 with available data). Renal referral was done in 21·4% (1625 of 7604) of the AKI cases, and renal replacement therapy was done in 59·3% (531 of 896) of those who had the indications. Delayed AKI recognition was an independent risk factor for in-hospital mortality, and renal referral was an independent protective factor for AKI under-recognition and mortality Interpretation AKI has become a huge medical burden in China, with substantial underdiagnosis and undertreatment. Nephrologists should take the responsibility for leading the battle against AKI. Funding National 985 Project of China, National Natural Science Foundation of China, Beijing Training Program for Talents, International Society of Nephrology Research Committee, and Bethune Fund Management Committee.

Cerebral microbleeds (CMBs) and lacunar infarcts are common manifestations of cerebral small vessel disease. However, the association between the location of CMBs and lacunar infarcts is unclear. Our study aimed to clarify the relationship between the location of CMBs and lacunar infarcts.This study retrospectively analyzed 166 patients with ischemic stroke or transient ischemic attacks admitted in the Geriatric Neurology Department of Chinese PLA General Hospital between February 2010 and December 2012. We collected clinical characteristics and risk factors of CMBs. The location of CMBs on T2*-weighted angiography was assessed by the Microbleed Anatomical Rating Scale. The number of lacunar infarcts and the severity of white matter hyperintensities were also recorded. The association between the location of CMBs and lacunar infarcts parameters was examined.CMBs were present in 77 (46.4%) patients. The presence [odds ratios (OR), 2.14; 95% confidence interval (CI), 1.02-4.48], number (OR, 1.17; 95% CI, 1.02-1.36 per lesion), severity (OR, 1.61; 95% CI, 1.07-2.42) of lacunar infarcts, and hypertension (OR, 5.76; 95% CI, 2.01-16.55) were independent risk factors for CMBs. Stratified by the location of CMBs, lobar CMBs and infratentorial CMBs did not show significant association with lacunar infarcts. Deep CMBs were significantly associated with the number (OR 1.18, 95% CI 1.03-1.36) and severity (OR 1.71, 95% CI 1.11-2.63) of lacunar infarcts. Moreover, the percentage of deep CMBs increased with the increased severity of lacunar infarcts (P = .003).Deep CMBs rather than lobar and infratentorial CMBs are associated with lacunar infarcts.

The package structure critically influences the major characteristics of semiconductor lasers, such as thermal behavior, output power, wavelength, and far-field distribution. In this paper, a new single emitter package structure called F-mount is designed and compared with the conventional package structure C-mount. The influence of package structure on their performances is characterized and analyzed. The thermal resistances of lasers with different package structures are calculated through simulation, and are contrasted with experimental results. Some devices are also tested for the maximum output power level. Under the continuous wave (CW) condition, the maximum power of F-mount reaches 12.6 W at 808 nm while the output power only reaches 10.9 W for C-mount. Under the condition of 0.5% duty cycle (100 μs, 50 Hz), the catastrophic optical mirror damage level reaches 58.7 W at 74 A for F-mount, and 54.8 W at 57 A for C-mount are reported for the first time. It is experimentally found that there is an obvious wavelength difference between the two type structure lasers: about 1.37 nm in CW mode and 2.89 nm in quasi CW mode. Theoretical analysis shows that red-shift and blue-shift is a result of external strain in the package process of F-mount and C-mount, respectively. It is also found that the package structure has an effect on the divergence angle of slow axis far fields, but little impact on that of fast axis far fields. The analysis shows that package structure has a strong influence on the performance of the laser; therefore, the package should be optimized to achieve better performance for some special applications.

The whispering-gallery-mode (WGM) photonic crystal microcavity can be potentially used for miniaturized photonic devices, such as thresholdless lasers. In this paper, we use plane wave expansion (PWE) method and study the WGM of H2 photonic crystal microcavities which are formed by removing seven center air holes in a photonic crystal. The WGM in these large-size cavities has some advantages compared with single defect WGM in the view of real device applications. We analyze the nearby air hole effect on WGM and conclude that WGM is more sensitive to moving towards the outside rather than moving towards the inside of a nearby air hole. In our case, if a nearby air hole is moved 0.1a away from the center, the WGM will disappear. If a nearby air hole is moved 0.6a towards the center, however, the WGM will still exit. We also analyze the structure with an air hole (rm= 0.2a) in the center of the microcavity, and we find that the WGM is not affected by the central hole sensitively. As we increase rm, the WGM remains unchanged until rm is 0.64 times greater than period a. It is found that the tolerance of WGM to the displacement of nearby air holes and the occurance of central holes is large enough to fabricate electrical injection structure.

A method based on the theory of transfer matrix to design the integrated microlens for the collimation of vertical-cavity surface emitting laser (VCSEL) array is presented. The integrated microlenses fabricated on the substrate directly and on a certain polymer material which is on the substrate are considered. The relationships between the radius of curvature, beam waist and the divergence angle after collimation are obtained with the help of ZEMAX. The results show that the devices with the divergence angle of 15° (1/e2) and beam waist of 2 μm can be improved to those with the divergence angle lower than 1°, and the devices with beam waist of 10 μm can be improved to those with the divergence angle lower than 3°, which is a good reference for manufacturing high-power devices with small divergence angle. The conclusions including increasing the thicknesses of both the substrate and polymer material and reducing the diameter of oxidized layer are drawn, which will be an important guidance for experiment research.

A 980 nm bottom-emitting vertical-cavity surface-emitting laser (VCSEL) array with a nonuniform linear arrangement is reported to realize high power with a Gaussian far-field distribution. This array is composed of five symmetrically-arranged elements of 200 μm, 150 μm, and 100 μm diameters, with the center spacing of 300 μm and 250 μm respectively. This structure makes it possible to discriminate against the higher order array supermodes. The theoretical simulation of the far-field distribution is in good agreement with the experimental result. An output power of 880 mW with a power density of 1 KW/cm2 is obtained. The divergence angle is below 20° in the range of operating current from 0 A to 4 A. The comparison between this nonuniform linear array and the conventional two-dimensional array is carried out to demonstrate the good performance of the linear array. A peak power of over 20 W is achieved under a short pulsed operation with a repetition frequency of 1 kHz.

With the improvement of output power, efficiency and reliability, high power semiconductor lasers have been applied in more and more fields. In this paper, a conduction-cooled, high peak output power semiconductor laser array was studied and developed. The structure and operation parameters of G-Stack semiconductor laser array were designed and optimized using finite element method (FEM). A Quasi-continuous-wave (QCW) conduction-cooled G-Stack semiconductor laser array with a narrow spectrum width was fabricated successfully.

This open-label extension (OLE) study evaluated the safety profile of ropinirole prolonged release (PR) administered for 24 weeks as adjunctive to levodopa in Chinese patients with advanced Parkinson's disease (PD).This was a 24 week, flexible-dose, OLE study in Chinese patients with advanced PD who received 24 week treatment with ropinirole PR in the preceding double-blind (DB), phase III study (NCT01154166) and had no break in receiving study treatment while switching from the DB study to the OLE study. In the OLE study, patients received ropinirole PR once daily, starting with 2 mg/d and increasing up to 8 mg/d at week 4 (2 mg increment/week); if tolerable, the dose could be further increased in 4 mg increments up to 24 mg/d according to clinical judgment. There were no efficacy assessments. Safety assessments included monitoring adverse events (AEs), neurological examination, Gambling Symptom Assessment Scale questionnaire, liver chemistry, and laboratory tests.Of the 295 enrolled patients, 282 completed the study. The most common reason for withdrawal was AEs (n = 9, 3.1%). The mean duration to ropinirole PR treatment was 173.1 days and an overall median daily dose of ropinirole was 8 mg (range: 2-24 mg). Overall, 114 (38.6%) patients experienced on-treatment AEs; the most frequent reported AEs ( ≥ 2%) were dyskinesia (6.1%), dizziness (4.1%), nausea (3.4%), hallucinations (3.4%), somnolence (2.7%) and decreased weight (2.4%). Sixty-eight patients (23.1%) experienced treatment-related AEs. Six patients experienced serious AEs (SAEs), of which hallucination was determined to be a treatment-related SAE. There were no other significant safety findings. No new safety signals for ropinirole were identified.The safety profile of ropinirole was consistent with the preceding DB study and also with the established safety profile for ropinirole. Results support the long-term use of ropinirole PR as an adjunctive to levodopa in Chinese patients with advanced PD. ClinicalTrials.gov identifier: NCT 1536574.

Objective To investigate the clinical features of dementia with Lewy bodies (DLB) in a Chinese population. Methods Computer-based online searches through China Biology Medicine disc and China National Knowledge Infrastructure were performed to collect case reports of DLB published between 1980 and 2012. Clinical characteristics were analyzed. Results A total of 18 studies comprising 35 patients (26 males and 9 females) were included. The mean age at onset was 67.2 ± 9.8 years. Onset was characterized by memory impairment and accounted for 58.8% of all cases, followed by parkinsonism (11.8%), visual hallucinations (8.8%), and compulsive personality disorder (2.9%). The other patients (17.6%) presented two of the three core features of DLB at onset. With disease progression, parkinsonism was reported in 100% of cases, followed by visual hallucinations (97.1%), psychiatric symptoms (85.7%), severe neuroleptic sensitivity (81.8%), fluctuating cognition (68.6%), repeated falls (40.0%), sleep disorders (22.9%), and transient loss of consciousness (17.1%). 26 patients who were subjected to Mini-Mental State Examination scored ≤ 24. 10 patients presented relative preservation of hippocampus and medial temporal lobe structures on CT/MRI scan. Occipital hypometabolism occurred in 2 of 3 patients who underwent SPECT/PET perfusion scan. 12 patients showed an increasing of slow frequency activity on EEG, prominently in frontal and temporal lobes. Conclusions DLB often strikes elderly individuals. Its clinical core features are dementia, fluctuating cognition, recurrent visual hallucinations and spontaneous features of parkinsonism. Neuropsychological, neuroimaging and EEG examinations may improve the diagnostic accuracy and discriminate DLB from other dementias.

Objective. To investigate the utility of AD8 for cognitive impairment in a Chinese physical examination population.Methods. Military cadres who took routine physical examination in Chinese PLA General Hospital from Jan 1, 2013, to Dec 31, 2013, were subjected to AD8 scale. Individual information such as age, gender, and education was also collected. All data were analyzed by SPSS 19.0.Results. 1544 subjects were enrolled in this study with mean age 75.4 ± 10.6 years. The subjects who scored 0 to 8 of AD8 scale were 1015, 269, 120, 60, 30, 14, 19, 8, and 9, respectively. Corresponding proportions were 65.7%, 17.4%, 7.8%, 3.9%, 2.0%, 0.9%, 1.2%, 0.5%, and 0.6%, respectively. The endorsement prevalence of 8 questions was 5.6%, 9.2%, 6.6%, 9.2%, 4.8%, 4.5%, 8.9%, and 24.1%, respectively. The endorsement prevalence of question 8 was significantly higher than others (P<0.05). 260 subjects were scored equal to or greater than 2. The abnormal rate was 16.9%. All the participants were stratified into 9 groups by age; the prevalence of dementia was highly correlated with age (P<0.01).Conclusion. AD8 scale is a convenient and effective tool for cognitive screening in routine physical examination population.

Cerebral microbleeds (CMBs) and white matter hyperintensities (WMH) are the most common manifestations of small vessel disease, and often co-occur in patients with cerebral vascular disease. Hypertension is widely accepted as a risk factor for both CMBs and WMH. However, the effect of hypertension on the association between CMBs and WMH remains unclear. We hypothesized that the relationship between CMBs and WMH is determined by hypertension. One hundred forty-eight patients with acute cerebrovascular disease who were admitted to PLA general hospital in Beijing, China from February 2010 to May 2011 were recruited in this study. CMBs on T2*-weighted angiography (SWAN) were assessed using the Brain Observer Microbleed Rating Scale criteria. The severity of the WMH was separately assessed as either peri-ventricular hyperintensities (PVH) or deep white matter hyperintensities (DWMH). The association among CMBs and the severity of WMH, and hypertension were determined. CMBs were found in 65 (43.9%) patients. The frequency of CMBs was related to the severity of DWMH and PVH. CMBs were more frequently observed in patients with hypertension compared to patients without hypertension (51.3% vs. 20.0%, p = 0.001). Hypertension was an independent risk factor for CMBs (odds ratio 5.239, p = 0.001) and DWMH (odds ratio 2.373, p = 0.040). Furthermore, the relationship between the presence of CMBs and the severity of DWMH was only found in patients with hypertension (r = 0.298, p

Aim The first evaluation of the efficacy and safety of ropinirole prolonged release (PR) as an adjunct to L-dopa in Chinese patients with advanced Parkinson's disease (PD) not optimally controlled with L-dopa. Methods In a 24-week, double-blind, placebo-controlled, parallel-group study, subjects with advanced PD were randomized 1:1 to ropinirole PR (N = 175) or placebo (N = 170) as add-on therapy to L-dopa. Primary outcome measure was change from baseline in awake time spent “off”. Starting dose of ropinirole PR was 2 mg/day, titrated based on clinical response (maximum 24 mg/day). Results At week 24, the mean dose of ropinirole PR was 11.4 mg/day with a mean reduction of L-dopa from 506.6 to 411.6 mg/day. Subjects receiving ropinirole PR experienced a significant reduction of “off” time (2.1 h) compared with placebo (0.4 h). Secondary outcome measures including hours of “on” time without troublesome dyskinesis were significantly increased in the ropinirole PR group (1.7 h) compared with placebo (0.3 h). Subjects classified as responders were significantly more frequent in the ropinirole PR (22.8%) than placebo group (2.5%). Efficacy outcomes including Unified Parkinson's disease Rating Scale and PDQ-39 subscales of mobility were significantly improved in the ropinirole PR versus placebo group. The most frequent adverse event experienced in the ropinirole PR group was dyskinesia. Conclusions This study demonstrated for the first time in Chinese subjects that ropinirole PR improved Parkinson's disease symptoms, permitting a reduction in L-dopa dose. The adverse events observed were consistent with the established safety profile of ropinirole, with no new safety signal identified.

This paper presents a stable all-fiber Q-switched Er-doped fiber (EDF) laser with WS2/fluorine mica (FM) as the saturable absorber (SA). The SA device is obtained by depositing WS2 nanosheet layers onto a 20 µm thick one-layer FM substrate using a thermal decomposition method. The modulation depth (MD) of the SA is 8.22% and the non-saturable loss (NL) is 16.38%. By inserting the SA into the EDF laser cavity, stable Q-switched operation is achieved with a central wavelength of 1567 nm. The repetition rate can be tuned from 20.98 kHz to 33.74 kHz and the pulse duration can be adjusted from 8.3 µs to 6.98 µs by increasing the pump power. The maximum output power and the maximum pulse energy are measured to be 2.07 mW and 61.4 nJ, respectively. The experimental results evidently show that the WS2/FM can be regarded as a high-performance SA for fiber lasers.

With the continuous increase of the output power of semiconductor laser array, the heat generation in the active region also increases continuously, which influences the performances and lifetime of semiconductor laser array seriously. In order to improve the performances and lifetime, understanding of the thermal behavior of high power semiconductor laser array packages and optimizing the thermal performance are crucial. By means of numerical analysis, a three-dimensional thermal model has been established, and the static and transient thermal characteristics in continuous-wave (CW) and quasi-continuous-wave (QCW) modes also have been studied systematically for a hard solder, conduction-cooled-packaged 808nm semiconductor laser array. Based on the thermal modeling and analysis, the approaches to reduce thermal resistance have been proposed. The results show that: compared with copper-tungsten (CuW), adopting the copper-diamond composite material as the submount can decrease the thermal crosstalk behavior between emitters, and reduce the thermal resistance by about 30%. In addition, a novel thermal design for the packaging structure of the mounting heat-sink is demonstrated, which has the ability of reducing the thermal resistance of the devices significantly.

Laser cladding has become a useful tool in materials processing for improving the surface properties of the substrate materials, and has been widely used in industry in recent years. In this paper, we study the 3000W CW laser cladding system based on the high power diode lasers. The beam control method is proposed to reduce the collimated beam pointing errors caused during the packaging of the laser stack. At the input current of 84A, the output power and the optical coupling efficiency of this laser cladding system are 3738W and 93.7%, respectively, and at work face the beam spot size is 2.5mm*7.9mm with symmetry intensity distribution. The laser cladding system is also used in cladding the nickel powder onto the iron substrate and the nickel powder can be clothed onto steel plate uniformly.

Vertical-cavity surface-emitting lasers emitting at 808 nm with unstrained GaAs/Al0.3Ga0.7As, tensilely strained GaAs(x)P(1-x)/Al0.3Ga0.7As and compressively strained In(1-x-y)Ga(x)Al(y)As/Al0.3Ga0.7As quantum-well active regions have been investigated. A comprehensive model is presented to determine the composition and width of these quantum wells. The numerical simulation shows that the gain peak wavelength is near 800 nm at room temperature for GaAs well with width of 4 nm, GaAs0.87P0.13 well with width of 13 nm and In0.14Ga0.74Al0.12As well with width of 6 nm. Furthermore, the output characteristics of the three designed quantum-well VCSELs are studied and compared. The results indicate that In0.14Ga0.74Al0.12As is the most appropriate candidate for the quantum well of 808-nm VCSELs.

Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan, Wangfujing, Beijing 100730, China Department of Neurology, Huashan Hospital Affiliated to Fudan University, Shanghai, China Department of Neurology, Beijing Tiantan Hospital Affiliated to Capital MU, Beijing, China Department of Neurology, Ruijin Hospital affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China Department of Neurology, The Chinese PLA General Hospital, Beijing, China Department of Neurology, The Second Affiliated Hospital Zhejiang University College Of Medicine, Zhejiang Province, China Department of Neurology, The 2nd Affiliated Hospital of Soochow University, Jiangsu, China Department of Neurology, The 1st Affiliated Hospital of Xi’an Jiaotong Univ, Shanxi, China Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China GlaxoSmithKline (China) R&D Company Limited, Shanghai, China GlaxoSmithKline (China) Investment Co, Ltd, Shanghai, China

High power and good beam quality of two-dimensional bottom-emitting vertical-cavity surface-emitting laser array with GaAs microlens on the substrate is achieved. Uniform and matched convex microlens is directly fabricated by one-step diffusion-limited wet-etching techniques on the emitting windows. The maximum output power is above 1 W at continuous-wave operation at room temperature, and the far-field beam divergence is below 6.6° at a current of 4 A. These properties between microlens-integrated and conventional device at different operating current are demonstrated.

A novel 980nm bottom-emitting VCSELs array with high power density and good beam property of Gaussian far-field distribution is reported. This array is composed of 5 symmetrically-arranged elements of 200μm,150μm and 100μm-diameter , with the center spacings of 300μm and 250μm respectively. The maximum power is 880mW at a current of 4A, corresponding to 1KW/cM 2 average optical power density. The differential resistance is 0.09Ω with a threshold of 0.56A. The novel array is compared with a 300μm-aperture-size single device and a 4 * 4 2-D array with 50μm element aperture size and 250μm centre spacing. The three devices have the same lasing area. The conclusion is that the novel array is better in the property of output power, threshold current, lasing spectra, far-field distribution etc.

Whispering-Gallery-Mode (WGM) photonic crystal microcavity is a kind of photonic crystal application and can potentially be used for miniaturized photonic devices, such as thresholdless lasers. In this paper we study the WGM of photonic crystal microcavities focusing on the so called H2 cavities which are formed by removing seven air holes. The WGM in these large-size cavities has some advantages compared with single defect WGM in the view of real device applications. We further add a central air hole in the cavity region to analyze the effect on WGM in the microcavity by finite difference time domain (FDTD) and plane wave expansion (PWE). It is found that the tolerance of WGM is large enough for the fabrication of electrical injection structure.

A new beam-shaping technique is proposed to improve the beam quality of a high-power diode laser area light source. it consists of two staggered prism arrays and a reflector array, which can cut the slow axis beam twice and rearrange the divided beams in fast axis to make the beam quality of both axes approximately equal. furthermore, the beam transformation and compression can be carried out simultaneously, and the assembly error of this technique induced by the machining accuracy of prism's dimensions also can be greatly decreased. by this technique, a fiber-coupled system for one three-bar laser diode stack is designed and characterized. the experimental results demonstrate that the laser beams could be transformed into the required distribution with similar to 93.4% reshaped efficiency and coupled into a 400 mu m/0.22 na fiber, which are consistent with the theory. (c) 2013 society of photo-optical instrumentation engineers (spie)

A 980 nm bottom-emitting vertical-cavity surface-emitting laser (VCSEL) with a p-contact diameter is reported to achieve high power and good beam quality. A numerical simulation is conducted on the current spreading in a VCSEL with oxidation between the active region and the p-type distributed Bragg reflector. It is found that, for a particular oxide aperture diameter, somewhat homogeneous current distribution can be achieved for a VCSEL with an optimized p-contact diameter. The far-field divergence angle from a 600 microm diameter VCSEL is suppressed from 30 degrees to 15 degrees, and no strong sidelobe is observed in the far-field pattern by using the optimized p-contact diameter. There is a slight rise in threshold and optical output power that is due to the p-contact optimization. By improving the device packaging method, the maximum optical output power of the device is 2.01 W.

A 980 nm bottom-emitting vertical-cavity surface-emitting laser array with a nonuniform linear arrangement is reported to realize emission with a Gaussian far-field distribution. This array is composed of five symmetrically arranged elements of 200 microm, 150 microm, and 100 microm diameter, with center spacing of 300 microm and 250 microm, respectively. An output power of 880 mW with a high power density of 1 kW/cm2 is obtained. The divergence angle is below 20 degrees in the range of operating current from 0 A to 6 A. The theoretical simulation of the near-field and the far-field distribution is in good agreement with the experimental result. The comparison between this nonuniform linear array, the single device, and the conventional two-dimensional array is carried out to demonstrate the good performance of the linear array.

Background Parkinson’s disease (PD) is a chronic, progressive and debilitating disease, which affects over 2.5 million people in China. PD is characterized clinically by resting tremor, muscular rigidity, bradykinesia and postural instability. As the disease progresses, additional complications can arise such as non-motor and neurobehavioral symptoms. Pharmacological treatment and surgical intervention for PD have been implemented in China. Until 10 years ago, there was lack of standardization for the management of PD in different regions and among different physicians, leading to different treatment levels in different regions and different physicians. Since then, the Chinese Parkinson’s Disease and Movement Disorder Society have published three versions of guidelines for the management of PD in China, in 2006, 2009 and 2014, respectively. Correspondingly, the overall level of treatment for PD in China improved. Objectives To update the treatment guidelines based on current foreign and domestic practice guidelines and clinical evidence, and to improve the treatment options available to physicians in the management of PD. Summary A variety of treatment recommendations in the treatment guidelines have been proposed, including physical activity and disease-modifying medication, which should be initiated at the early-stage of the disease. The principles of dosage titration should be followed to avoid acute adverse reactions to the drugs, to achieve a satisfactory clinical effect with a low dose and to reduce the incidence of long-term motor complications. Moreover, different treatment strategies should be considered at different stages of the disease. Importantly, treatment guidelines and personalized treatments should be valued equally. A set of treatment recommendations has been developed to assist physicians to improve and optimize clinical outcomes for patients with PD in China.