Objective To explore the curative effects of repetitive transcranial magnetic stimulation ( rTMS) therapy on subcortical ischemic vascular disease( SIVD) patients with mild cognitive impairment.Methods Sixty-one SIVD patients with mild cognitive impairment but did not meet the diagnostic criteria for vascular dementia were enrolled and randomly divided into the treatment group (n=31) and the control group (n=30) in accordance with international common randomization form,TMT-A、TMT-B、VFT、AVLT score and P300 latency and amplitude changes were compared between the two groups before and after treatment.Results TMT-A、TMT-B、VFT、AVLT showed no difference before treatment between the two groups, but improved significantly after treatment in the treatment group ( P=0.040;P=0.041;P=0.034;P=0.010 ) .the results were also significantly different from the control group after treatment( P=0.019;P=0.009;P=0.044;P=0.045 ) .In the treatment group, P300 latency after treatment was significantly reduced than that before treatment (P=0.045),which was also significantly reduced from the control group ( P=0.025 ) , but P300 amplitude did not reach statistically significant difference before and after treatment in the treatment group.In the control group, P300 latency and amplitude did not reach statistically significant difference before and after treatment.Conclusion TMS therapy can improve cognitive function in SIVD with mild cognitive impairment.

Objective To study the clinical manifestations,endoscopic features,pathological features,treatment and prognosis of patients with duodenal neuroendocrine carcinoma (DNEC).Methods The clinical data of 9 patients with duodenal neuroendocrine carcinoma who were admitted to our hospital from December 2006 to December 2014 were retrospectively analyzed.Results There were 6 males and 3 females.The mean age was 61.5 years (range 48 ～75 years).The clinical manifestations were abdominal pain (n =7),jaundice (n =4),melena (n =1) and asymptomatic (n =1).The DNEC was usually solitary in the duodenum.The operations included duodenopancreatectomy (n =5),surgical resection (n =2),subtotal gastrectomy (n =1),and 1 patient was palliated by common bile duct stenting using an endoscopic retrograde cholangio-pancreatographic (ERCP) approach.The patients were followed up for 3 ～ 40 months after operation.For the 5 patients who underwent radical excision 4 were alive.One patient died from liver metastasis.For the 4 patients who underwent palliative therapy,one was alive,two died and one lost to follow-up.Conclusions The clinical manifestations of duodenal neuroendocrine carcinoma were non-specific.Endoscopic,pathologic and immumohisotochemical tests were important in the diagnosis.Surgical resection improved the prognosis of these patients.