BACKGROUND: Chinese character is the only non-alphabetic system of writing, the patterns of semantic symbol, phonetic symbol and sign in the cognition of Chinese characters, it is the combination of form, sound and meaning, and its cognitive pattern, pathway, analytical judgement of semantic and storage are different from those of western alphabetic system of writing, and the processing of Chinese characters maydifferent from that of alphabetic system of writing.OBJECTIVE: To localize the motor language center of the healthy volunteers whose native language is Chinese by means of the equivalent current dipole (ECD) and synthetic aperture magnetometry (SAM) of magnetoen cephalography (MEG).DESIGN: A single-sample univariate analysis.SETTING: Department of Neurology, Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences.PARTICIPANTS: Ten healthy volunteers whose native language is Chinese were selected from the postgraduates and training participants in the Department of Neurology, Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences between July 2003 and April 2005, they were all right handedness and had no speech disorders and cognitive impairments, and all accepted training of language task.METHODS: All the healthy subjects were given the language task stimulation of reading words and pseudowords silently, the number of the silently read nouns, appearing time for each noun and the interval between two tasks were strictly matched, ① Words were the common high-frequency characters, accorded to the law of Chinese characters components, and had 4-13 strokes. ② Pseudowords, composed by Chinese characters made-up software, accorded to the made-up law of Chinese character, but could not compose the stroke assemble of the character, and had 4-13 strokes. The evoked magnetic field produced after the stimulation was recorded with MEG, the collected data were overlapped with MRI to obtain the localization of language functional areas.RESULTS: All the 10 volunteers finished the test and entered the analysis of results. Both words and pseudowords evoked obvious late magnetic reaction waves in bilateral cerebral hemispheres, the motor language centers both located at posterior inferior frontal gyrus.CONCLUSION: The motor and classic motor language centers are general concordant in the normal people whose native language is Chinese, that was to say, the motor language center localizes at posterior inferior frontal gyrus of normal people whose native language is Chinese.

OBJECTIVE: About 70% patients with stroke have dysfunction at various degrees in clinic, especially aphasia would affect their social communication and even offer a serious economic load for family and social. This paper aims to summarize the relevant articles on aphasia recovery so as to provide researching evidences in the future. DATA SOURCES: Relevant articles were retrieved from the Medline with the key words of "aphasia, recovery, language, recovery" in English from January 1980 to January 2004. STUDY SELECTION: All articles were selected firstly, those which were related to aphasia recovery were selected, and the non-randomly clinical papers were excluded. The full text of rest was looked up to determine whether they were randomized controlled studies or not. Randomized controlled researches were regarded as inclusion criteria regardless of blind way. DATA EXTRACTION: Among 22 articles on aphasia recovery, 12 were selected according to inclusion criteria and 10 were excluded because of duplicated papers.DATA SYNTHESIS: Recovery of language function was related to sex,age, ducational degrees, characteristics of lesion, range of lesion, duration from episode to language recovery, insight and self redress of language disorder. Therefore, there were various findings and views for previous re searches on mechanism of aphasia recovery. CONCLUSION: There is not uniform conclusion on mechanism of aphasia recovery. Compliance of language function in brain may be a mechanism of aphasia recovery.

BACKGROUND: Most studies believed that lesion sites are decisive to the attack and types of aphasia, which is also in disputation.OBJECTIVE: To classify and evaluate aphasia with CT and MRI examinations, so as to reveal the association between aphasia types and lesion sites.DESIGN: A cross-sectional study.SETTING: Department of Neurology, Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences.PARTICIPANTS: The lesion sites were selected from 1 198 patients with cerebral infarction, who were hospitalized in the stroke unit of the Department of Neurology, Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences between February 2002 and February 2005, the diagnosis accorded with the diagnostic standard of cerebral infarctionset by National Meeting for Cerebrovascular Disease, and the patients with cerebral infarction were caused by lesions of left cerebral hemisphere ry school and above, the intellect was normal before attack, and there was score of Western battery aphasia was ＞ 93.8. Totally 221 males and 104 females were enrolled, and the average age was (68.72±4.56) years.and received MRI examination within 1 week after admission. The data collection and treatment were finished with the Siemens Trio 2003T magaphasia of the patients was classified and evaluated with the Western battery aphasia by professional language therapist within 2 weeks after adtic aphasia examination severity grading standard by the same language therapist on the same day of Western battery aphasia. There were 6 grades, grade 0 was taken as meaningless language or auditory understanding ability, and grade 5 as extremely few differentiable language disorders, the patients could feel some difficulties subjectively, but the hearer was uncertain to obviously detect.MAIN OUTCOME MEASURES: Association between aphasia types and lesion sites; Grading of aphasia severity. Aphasia not caused by the involvement of language centers: Of the 1 198 patients with cerebral infarction, the Broca area in 5 cases and Wernicke area in 4 cases were involved, and did not cause aphasia syndrome in the Western battery aphasia showed that 83 cases had Broca aphasia, 48 cases Wernicke aphasia, 58 cases complete aphasia, 12 cases conduction aphasia, 36 cases transcortical motor aphasia, 17 cases transcortical sensory aphasia, 19 cases transcortical mixed aphasia and 52 cases nominal aphasia. The lesions located at typical language center in 240 cases and at nonaphasia examination severity grading standard: It was grade 0 in 84 cases, grade 1 in 79 cases, grade 2 in 77 cases, grade 3 in 63 cases and grade 4 in 22 cases, and the typical language centers were involved in most of the patients of grade 0 and grade 1.CONCLUSION: The association between types and lesion sites of most aphasia are in accordance with the typical aphasia mode, but it was not completely accordant in a few aphasias, the lesion of non-language centers can also cause aphasia, and the aphasia is greatly severe in the patients with the lesion site of language centers.

BACKGROUND: Primary progressive aphasia is a degenerative disease of nervous system clinically characterized by the progressive decrease of speech ability and the relatively reserved memory. OBJECTIVE: To investigate the characteristics of speech dysfunction and the clinical features of primary progressive aphasia we by reported onel patient with primary progressive aphasia. DESIGN: A case analysis. SETTING: Department of Neurology, Beijing Tiantan Hospital affiliated to Capital University of Medical Sciences. PARTICIPANT: One male patient of 56 years old with primary progressive aphasia was selected from the Department of Neurology, Beijing Tiantan Hospital in March 2004, he had got education in senior middle school. The patient had been unable to tell the names of daily living objects at the beginning of 2001. Not only his ability of listening comprehension had gradually declined, but his characters had gradually changed except that his memory had not been affected obviously since 2003. Although he was able in self-care now, he could not normally work. METHODS: ① The spoken fluent types of the patient were evaluated with the standards for the fluency of spoken language in Aphasia battery of Chinese. Western battery aphasia was used to assess the type of aphasia of the patient. Boston diagnostic aphasia examination severity grading standard was applied to grade the severity of aphasia. ② The cognitive psychological tests of visual character-figure matching, denomination for figures and oral reading were used to judge whether the patient had verb-noun dissociation. ③The memory of the patient was assessed with clinical memory scale. MAIN OUTCOME MEASURES: ① spoken fluency, the type and grade of aphasia; ② condition of verb-noun dissociation for the patient; ③ memory of the patient. RESULTS: ① Examination of aphasia: The patient presented the spontaneous talking that named the fluent type, there were wrong meanings in his talks so that he was diagnosed as sensory aphasia. The severity of aphasia was separated into grade 3 levels. ② Cognitive psychological test: The correct rates of verbs and nouns in the test of denomination for figures were 15% and 53% respectively, and there was obvious difference (t=0.231, P ＜ 0.05). ③ Clinical memory scale: The memory quotient was 111,and the clinical memory grade was higher than normal. CONCLUSION: The most outstanding clinical characteristics of patients with primary progressive aphasia is speech dysfunction, and there is verb specific injury.

Safety is a critical link restricting the development of TCM injections.Hospital centralized monitoring is of importance in the safety evaluation of TCM injections.However,the results of centralized monitoring studies usually deviated from the actual situation because of problems in design and process quality.Our research team have completed several projects over centralized monitoring in recent years.Based on the previous research experience,this paper mainly discussed the current statuation,the significance and methods for standard process of hospital centralized monitoring in regard to TCM injections,in order to improve the quality of centralized monitoring studies and provide technique support for recognizing the safety of TCM injections.

Objective To assess the epidemiological characteristics of hypertension and its attributing factors in Heilongjiang province and establish a comprehensive basis for the prevention and control of hypertension in this region. Methods Using the stratified chunk method, a survey lasting 50 years was conducted on a sample of 299 677 (including i 58 782 males and 140 895 females) patients, aged 15 and above, residing in both rural and urban areas of Heilongjiang province from 1958 to 2007. Both blood pressure measurement and analysis on attributing factors of hypertension were carried out in 1958, 1979, 1991, 1999 and 2007. Results The prevalence of hypertension was significantly higher in Heilongjiang than in other provinces. It elevated annually, reaching a 3-fold increase in 50 years with an accelerating pace ( 17.06% to 25. 69% ) in the recent 8 years. Among the people examined, the prevalence of hypertension increased with aging. Furthermore, the prevalence of hypertension varied among different professions. Office workers had the highest prevalence (41.67%). Compared with female population, male participants had a much higher prevalence before the age of 55 (P < 0.0001 ). Body mass index, gender, hypertriglyceridemia, age, low-high density lipoprotein cholesterol and family history were identified as major risk factors for the development of hypertension in Heilongjiang province. However, the awareness (48. 90% ), treatment (25.33%) and control (4. 32% ) rates of hypertension in this region were relatively low. Conclusion The results of the present study identified Heilongjiang province as a high-risk region for hypertension. It also suggests the necessity to plan and implement actions for the effective prevention and treatment of hypertension in this region.

Objective To study the incidence, risk factors and prognosis of central nervous system (CNS) complications after hematopoietic stem cell transplantation ( HSCT) in order to prevent or reduce its occurrence, provide better diagnosis and treatment and improve the survival of the patients.Methods A total of 640 patients who consecutively underwent HSCT in our hospital between May 2001 and December 2007 were included.The clinical outcomes of the patients who developed CNS complications were analyzed.Results The patients received stem cells from haploidentical family members ( Haplo, n = 289 ) , identical siblings (IS, n = 237) , unrelated donors ( URD, n = 83) , unrelated cord blood (n = 14) , syngeneic siblings (n = 9 ) or autologous peripheral blood ( n = 8 ).Fifty-seven of 640 patients (8.9% ) developed CNS complications.The incidences were 12.0%, 13.5% and 3.4% in URD-HSCT, Haplo-HSCT and IS-HSCT respectively ( P <0.001).The incidences of CNS complications were 19.4% and 8.3% in cases who received or did not receive conditioning with TBI ( P = 0.047 ).There was no significant difference in the incidences of CNS complications between children (15.3% ) and adults(8.3% ) (P = 0.072).Similar incidences of CNS complications were seen in patients with hematological malignancies (8.9%) and non-malignant hematological disorders (7.7%)(P = 1.000).Five of the 57 patients developed two kinds of CNS complications.The patterns of CNS complications included relapse (17 cases) , infections (15 cases) , cyclosporine or FK506 encephalopathy (9 cases) , cerebral hemorrhage ( 8 cases) , cerebral infarction (2 cases), Wernicke's encephalopathy (1 case), skull fracture (1 case), drug-related meningitis (1 case), hepatic encephalopathy (3 cases), post-transplant lymphoproliferative disorder (1 case) and undetermined causes (4 cases).The overall mortality in the patients who developed CNS complications was 57.9% and 66.7% of them died of CNS complications.Conclusions CNS complications are not uncommon after HSCT and they have high mortality and poor prognosis.Our data suggest that haplo-HSCT,URD-HSCT and conditioning with TBI, but not the age and types of hematological diseases are the risk factors for development of CNS complications.Relapse and infections are the most common CNS complications in HSCT recipients.Early diagnosis and appropriate management are crucial to the improvement of clinical outcomes in these patients.

According to the related requirements of safety reevaluation of TCM injections,hospital centralized monitoring of the safety of TCM injection was consecutively pressed ahead.Centralized security monitoring was a large-scale real world research involving numerous data acquisition,transmission,verification and analysis.The quality of data acquisition and data verification directly affected the authenticity and reliability of research data and results.Therefore,data management played a significant role in the safety monitoring of TCM injections.Based on the analysis of previous researches,this paper discussed the implementation content,links and the frequent problems and corresponding solutions of data management during the safety monitoring of TCM injections,combining with the experience in the implementation of projects.

The implementation process management plays a important role for the quality of centralized safety monitoring study of post-marketing Chinese medical injections.One of the critical link is hospital.Currently,there is no principle or specification for hospital choosing,number of monitoring points,data collection responsible part and forms of data collection as well.These issues caused uneven quality,huge differences in results and questioned conclusion.Based on the previous research experience,this paper focused on discussing the link of hospital where research data may be influenced,and proposed some suggestions.

A facial allotransplanted patient presented hyperglycemia with blood glucose ranged 14. 3 -33. 3 mmol/L after receiving immunosuppressive drugs and glucocorticoids. To control the blood glucose level, the patient was treated with two subcutaneous doses of 10 U human neutral protamine hagedorn (NPH) insulin, and the fasting glucose level came down to 3. 6 - 9. 4 mmol/L. Then the continuous subcutaneous infusion of insulin aspart ( Novo Industri) was administrated (from 96 to 21 U/d) , and the fasting blood glucose levels were 3. 9 -4. 6 mmol/L. With oral administration of Metformin and Repaglinide, the fasting blood glucose was maintained to 4. 3 -5.9 mmol/L. With these medications, the blood glucose level of the patient was under good control and the acute and chronic complications of hyperglycemia were effectively prevented.