Undergraduate tutorial system is progressively rising in many medical colleges of China.We should explore feasible ways in the Chinese context according to our national conditions and teaching characteristics of medical students.Undergraduate tutorial system has been implementing for several years in department of Neurology of Changhai hospital attached to the second military medical college,where the tutor have done preliralnary research on training students1 comprehensive and professional quality and the problems of tutorial system

Objective To study the effectiveness of Huperzine A,Nimodipine and the combinative utilization to age associated memory impairment(AAMI) and the influence of those to the plasma total antioxidant capacity(TAC) and calcium of platelet.Methods 140 patients with AAMI were randomly divided into 4 groups(35 cases in each group).Huperzine group administrated with Huperzine A 100 ?g thrice a day;Nimodipine group administrated with Nimodipine 30 mg thrice a day;combined group administrated with Huperzine A 100 ?g twice a day and Nimodipine 30 mg thrice a day;control group administrated with Vitamin B6 10 mg thrice a day.All the cases were treated for 6 weeks.Before and after treatment,the memory function were tested by WMS.The levels of plasma TAC and calcium of platelet were also measured at the same time.Results After treatment,the scores of WMS,the levels of plasma TAC and calcium of platelet in Huperzine A group,Nimodipine group and combined group were higher than before treatment and those in control group(all P

Objective To investigate the levels and the abnormal incidences of apolipoprotein and other related indicators in health people in Hunan province,and to provide data for establishment of reference intervals in Hunan province.Methods The people with physical examination (n =341) were chosen from the Second Xiangya Hospital of Central South University during August 2014 ～ October 2014 (male,n =239;female,n =102) with age from 22 to 77 years old.All people were divided into 4 groups according to their age:group A aged from 22 to 42 (35.56 ± 5.39),group B aged from 43 to 48 (45.59 ± 1.59),group C aged from 49 to 55 (51.19 ± 1.81),and group D aged from 56 to 77 (63.08 ±5.84).The levels of apoAI,apoB,Lp (a),hypersensitive C-reactive protein (hs-CRP),and homocysteine (HCY) were detected with automatic biochemical analyzer,and were compared among different age groups and between male and female in each age group.Results Compared to male,the average levels of apoAI,and Lp (a) were significantly increased (P ＜0.05),and apoB,hs-CRP,and Hcy were significantly decreased (P ＜ 0.05) in the female.The levels of apoB,and hs-CRP were significantly different among 4 age groups (P ＜ 0.05).The abnormal rate in each index among 4 age groups was not significantly different (P ＞ 0.05).For groups A,B and D,the abnormal rate of Hcy was significant higher in male relative to female (P ＜ 0.05).Conclusions All the indices have significant difference between male and female (P ＜0.05).The levels of apoAI,Lp (a),hs-CRP,and Hcy do not change with the changed age.However,apoB has a certain relationship with age.The level and abnormal rate of Hcy are significantly higher in male relative to female.

Objective To understand the present situation of happiness of the elderly living in nursing homes and discuss the related factors.Methods Using the method of questionnaire,the happiness of the elderly over sixty years old and its influencing factors in eleven nursing homes in Changchun were discussed.Results Among many influencing factors,health status,the reasons for living,marital status and self-care status affected the happiness of the elderly in nursing homes.Above all,the health status had the most significant effect on happiness.Conclusions Improvement of the health level of the elderly in nursing homes can improve the happiness of them.

Cognitive impairment includes several clinical processes from mild cognitive impairment to dementia, and now it has been a serious public health problem, as there is no effective treatment, it has caused a heavy economic and psychological burden on the family and society, therefore, it seems important to find effective intervention means.Vitamin D is an essential nutrient element for the human body, more and more evidences show that it also participates in many extraskeletal biological reactions, such as nervous system regulatory processes, in addition to calcium and phosphorus metabolism.Several researches have revealed that Vitamin D deficiency is associated with impaired cognition, the mechanisms mediating this link are poorly understood, what's more, for further clinical application, we need to solve the problems like choosing the suitable populations and drug dosage, therefore, this article summarizes and analyzes the effects of serum Vitamin D levels on the cognitive function of different populations, the research progress of Vitamin D intervention research and its possible mechanism of action, hoping to provide references for the clinical application of Vitamin D in the treatment of cognitive impairment.The results show that Vitamin D deficiency is related to the decline of cognitive function in different populations, and Vitamin D can improve cognitive function through reducing Aβ toxicity, anti-inflammatory and anti-oxidative stress and other mechanisms, its supplementation is expected to be an important measure of treating cognitive impairment, in the future, large-scale longitudinal cohort studies are needed to determine the optimal dosage and duration of treatment.

Objective:To study the relationship between somatization symptoms and body mass index (BMI), sleep and cognitive function in patients with depression.Methods:A total of 119 patients with depression were selected from January to December in 2019.According to the score of patient health questionnaire-15(PHQ15), they were divided into mild somatization group ( n=75) and moderate severe somatization group ( n=44). Hamilton depression scale-24(HAMD-24), patient health questionnaire-15, Pittsburgh sleep quality index(PSQI) and Montreal cognitive assessment(MoCA) were used to evaluate all subjects.SPSS 23.0 software was used for data analysis.Independent sample t-test was used to compare BMI, sleep and cognitive function scores between the two groups.Pearson correlation analysis was used to study the correlation between somatization symptoms and sleep quality and cognitive function. Results:There were significant differences in BMI((21.70±3.09)kg/m 2, (23.31±3.51)kg/m 2), PSQI((12.56±4.37), (14.37±3.72)), sleep quality(1.87±0.86), (2.21±0.80)), sleep disorder ((1.24±0.59), (1.65±0.53))and daytime dysfunction((2.45±0.81), (2.77±0.48)) between the two groups ( t=-3.783--2.133, all P<0.05), but no difference was found in cognition ( P>0.05). Correlation analysis showed that after controlling HAMD, PHQ-15 was positively correlated with PSQI, sleep quality, sleep disorder, daytime dysfunction and language score in MoCA ( r=0.205-0.298, all P<0.05). Conclusion:The severity of somatization in patients with depression is related to BMI, sleep quality, sleep disorder, daytime dysfunction and language function, suggesting that they may play an important role in the pathogenesis of depression with somatization.

Migraine is one of the most common primary headache with high disability rate and heavy disease burden. Cardiovascular diseases are common comorbidities in migraine patients; different cardiovascular diseases have different correlations with migraine. For some cardiovascular events with poor prognosis, timely discovery and preventive measures can effectively help to avoid the adverse events. The article illustrates the associations between different cardiovascular diseases and migraine to improve the clinician's attention to such patients.

Objective? To systematically analyze the research status and development trend of postoperative sleep nursing from 2008 to 2017 in China. Methods? We systematically retrieved literatures on postoperative sleep nursing published in Chinese Biology Medicine disc (CBM), China National Knowledge Infrastructure (CNKI), WanFang Data and Vip Database from 1st January 2008 to 31st December 2017. The bibliometrics was used to statistical analysis. Results? A total of 485 literatures met criteria were included finally. From 2008 to 2017, the number of literatures had a growth trend every year. Literatures were published in 145 journals in China with 8.0% in the nursing core journals. A total of 10.1% of the researches had fund support, 61.6% of literatures had been quoted and 10.2% of them were quoted ≥10 times. Authors were from 28 provinces in China and the cooperative rate was 53.0% with 2.21 for the cooperative level. The research type focused on intervention study, and diseases were main in cancer, orthopedics and mixed surgery patients, and research contents mainly included symptoms of decline, influencing factors and intervention of postoperative sleep quality. Conclusions? In China, researches on postoperative sleep nursing have development tendency but with problems such as uneven regional development, insufficient research support, single assessment tool and imperfect study design. The overall quality needs to be improved.

Objective:To introduce a surgical technique of implant-based immediate breast reconstruction using the "latent orifice" procedure after skin-sparing mastectomy and to investigate the clinical value of this procedure.Methods:Clinical data of 72 patients who underwent immediate breast reconstruction using the "latent orifice" procedure (we placed the silicone prosthesis in a "latent orifice" consisting of fascia and underlying muscles) from Jan. 2016 to Dec. 2019 were collected. Characteristics of surgical technique and the effect of the reconstruction surgery were analyzed.Results:70 patients underwent nipple-areola complex sparing mastectomy (NSM) . Two patients’ nipples were resected due to intraoperative frozen pathology suggesting carcinoma existing in the nipples. The nipple epidermal necrosis occurred in 3 patients. No seroma, incision infection or capsular contracture occurred. According to the evaluation scale, the overall aesthetic score was 9.39 points. The average score of each subscale was: 9.57 points for breast volume, 9.43 for breast contour, 9.84 for placement of implant, 9.38 for scars, 9.27 for lower pole projection and 9.21 for inframammary fold definition. BREAST-Q questionnaires were filled by patients. Scores of psychosocial well-being ranged from 62 to 93 points, with the median score of 77 points. Satisfaction with breasts scores ranged from 58 to 100 points, with the median score of 71 points.Conclusion:The "latent orifice" procedure is a simple, safe, practicable, aesthetic and satisfying type of immediate implant-based breast reconstruction, which is worth practicing and promoting.

Objective:To report the clinical features, imaging findings and gene mutation features of a Chinese family with cerebral autosomal dominant arteriopathy with subcritical infarcts and leukoencephalopathy (CADASIL).Methods:We summarized the clinical and imaging features of a CADASIL family confirmed by gene sequencing. NOTCH3 gene sequencing was conducted for the proband, and the structure of the protein encoded by the mutant gene was predicted. Results:The patients in this family mainly presented with recurrent lacunar infarction and hypertension, without headache and emotional disorders such as anxiety or depression. Head MRI of the proband showed multiple lacunar infarctions and extensive white matter degeneration. Susceptibility-weighted imaging showed multiple small intracranial hemorrhages. The analysis of NOTCH3 gene showed that the proband had c.697T>A mutation. The 3D structure prediction of the protein encoded by this mutation locus showed that this locus could lead to the conversion of cysteine to serine at the 233rd position. Conclusions:The patients of this CADASIL family have a c.697T>A mutation of NOTCH3 gene. This mutation may cause the change of amino acid in the structure of the wild type Notch3 protein, which may lead to increased formation of β-folding structures in the surrounding region, thus changing the structure and function of protein and causing disease.