Objective To investigate the therapeutic effect of combination of memantine and donepezil on cognitive mental symptoms in patients with Alzheimer's disease.Methods Seventy cases elderly patients with Alzheimer's disease were randomly divided into two groups,memantine and donepezil group(treatment group)with 35 cases,donepezil hydrochloride and olanzapine group(control group)with 35 cases.Scoring in before treatment and 6,12 weeks after treatment in application of rosa linked to Alzheimer's disease(ROSA)and the neuropsychiatric Inventory(NPI)assessment,montreal cognitive assessment scale(MoCA scale)were assessed.Results ROSA scores in before treatment and 6,12 weeks after treatment of treatment group and control group was(75.14±17.20)points and(73.97±17.29)points,(89.77±17.14)points and(80.84±15.31)points,(100.30±14.47)points and(89.31±13.30)points,there were statistically significant differences before treatment between the two groups(P＜0.05),there were statistically significant differences 6,12 weeks after treatment inner groups(P＜0.05).MoCA,NPI and NPI care distress comparison between groups differences were not statistically significant(P＞0.05).Conclusion The combined treatment of memantine and donepezil in Alzheimer's disease can improve cognitive function and mental symptoms,communication,etc.The effect of agitation or attack than the control group is significantly different.

The emerging oating acupuncture therapy is one of the most innovative acupuncture therapy recently,with an exact e cacy to treat clinical pain.However,from current research of oating acupuncture therapy,several major misunderstandings and confusions exist.Studying from the perspective of 'Acupuncture needle reaches disease location',this paper integrates traditional Chinese medicine theory,and aims to promoting the development of the traditional Chinese medicine theory of oating acupuncture therapy.

Objective This paper reviewed the researching progress on chronic renal failure(CRF)of traditional Chinese medicine in the recent ten years,hoping to provide theoretical evidence for both clinical treatment and scientific study.Methods Literatures on CRF researched by traditional medicine in the recent ten years were summarized and analyzed.Results At present,the studies on CRF by traditional medicine focus on its etiological factors,pathogenesis and treatment according to syndrome differentiation,which revealed the mechanism of its curative effect on different levels.Conclusions Traditional medicine has good curative effect on CRF,and it is worthy of being developed and investigated.

Objective To investigate the correlation of traditional Chinese medicine (TCM) syndrome types of chronic gastritis with Helicobacter pylori (Hp) eradication rate after anti-Hp treatment. Methods A total of 180 chronic gastritis patients with Hp infection were differentiated into spleen-stomach insufficiency syndrome, spleen-stomach dampness-heat syndrome, and liver depression and qi stagnation syndrome, and each syndrome group had 60 cases. Patients in each group were evenly divided into two subtypes, and were treated with triple therapy or quadruple therapy for 10 days respectively. After treatment, the Hp eradication rate in each group was compared. Results (1) The overall Hp eradication rate was 78.3%. No matter after triple therapy or quadruple therapy, patients with spleen-stomach insufficiency syndrome had the lowest Hp eradication rate (61.7%), which was lower than that of the patients with spleen-stomach damp-heat syndrome (88.3%) and the patients with liver depression and qi stagnation syndrome (85.0%), the difference being statistical significance (P < 0.05 or P < 0.01). However, the difference of Hp eradication rate between spleen-stomach damp-heat group and liver depression and qi stagnation group was not statistically significant (P>0.05). (2) A total of 10 cases had adverse reaction such as nausea and vomiting, stomachache, and gastric distention, 8 cases from spleen-stomach insufficiency group, one from spleen-stomach dampness-heat group, and one from liver depression and qi stagnation group. Spleen-stomach insufficiency group had higher incidence of adverse reaction than the other two groups (P < 0.05). Conclusion The Hp eradication rate after anti-Hp treatment varied in chronic gastritis patients with different TCM syndrome types, and the rate in patients with spleen-stomach insufficiency syndrome was lower than that of the patients with spleen-stomach damp-heat syndrome and the patients with liver depression and qi stagnation syndrome no matter after triple therapy or quadruple therapy.

Objective Postictal language testing can provide useful diagnostic information for seizure lateralization.However no such a study based on non-English language was done previously.We investigated the latency of language recovery in Chinese patients with temporal lobe epilepsy (TLE).Methods Complex partial seizures in patients with TLE were extracted from our video-electroencephalogram (EEG) database.For all patients,consciousness testing started as soon as seizures were detected.When they were alert and cooperative,they were asked to read out a sentence “昨晚他们听到老在电台里讲话”which was printed on a card.When the patients were able to read the sentence correctly,the language function was considered recovered.Results Totally 65 complex partial seizures from 22 cases of TLE (11 left and 11 right) were included.Patients were cooperative to language testing in 54 seizures (83％).The latency for consciousness recovery (CRL) and latency for consciousness language recovery (LRL) were not associated with seizure duration,but the seizure lateralization.The CRL (median,161 s) and LRL (281 s) in the left TLE were statistically significantly longer than that in the right TLE (30 s,54 s respectively).Using 150 s recovery time as bound language recovery ratio was 87％ (27/31) in right TLE and 13％ (3/23) in left TLE.Conclusion Postictal language testing based on ideographic Chinese words helps to establish seizure lateralization in patients with TLE.

Objective:To explore the association between different urbanization levels and non-commu-nicable diseases (NCDs)in China and provide suggestions on designing relevant health policies in the ur-banization process.Methods:We obtained health-related data from China Health and Retirement Longi-tudinal Study (CHARLS)201 1 .This study used multistage sampling in design stage and covered 1 50 districts/counties,representative at the levels of the country.Geo-information system (GIS)method was used to get district areas data,and in combination with the Sixth National Census population data,we computed the population density which was regarded as the proxy variable of urbanization level in every city.The Logistic model was used to explore the effect of urbanization level on hypertension,diabetes, smoking,drinking,overweight and obesity.Results:Compared with other cities in China,Shanghai and Shenzhen,with the population density of more than 3 000 people per km2 ,were the cities with highest urbanization level.From the map of urbanization distribution across China,it was found that the urbani-zation levels of the northwestern districts were lower than those of the southeastern and coastal districts. The hypertension rate increased with the development of urbanization but there was no statistical signifi-cance.The proportion of patients with diabetes went up first and then saw a decrease trend in the process of urbanization.Drinking rate,overweight rate and obesity rate had similar trends,falling to their lowest point when urbanization level equaled 737,1 1 86 and 1 353 people per km2 respectively and then ex-perienced upward trends.By contrast,smoking rate declined first and then went up (the turning point was 1 029 people per km2 ).Conclusion:Different urbanization levels have different effects on NCDs, health-related behavior,overweight and obesity.Low urbanization level may create negative impact on health while high level can pose positive effect and increase people’s health condition possibly due to the improvement of health care accessibility and the quality of living environment.Policy-makers should spe-cially focus on different residents’health problems in different periods of urbanization,such as the impact of environmental pollution,health resources’allocation and accessibility of health services.It is necessa-ry to reduce or avoid the negative effect of urbanization on NCDs during the local development process to face the NCDs’threat.

Objective To investigate the CT features of nodular or mass-like type pulmonary cryptococcosis(PC). Methods A total of 52 cases with nodular or mass-like type PC confirmed by pathological examinations at Fuzhou Pulmonary Hospital of Fujian from January 2008 to December 2012 were studied. Each patient underwent a breath-hold MSCT scan and contrast enhanced CT was performed in 19 patients. The data including lesion size, number, distribution, density, performance of enhanced CT scan and accompanying signs were analyzed. Each CT accompanying sign was compared between nodular lesions and mass-like lesions using χ2 test,continuous correction χ2 test or Fisher exact test. Results Of all the 52 patients, pulmonary cryptococcosis was consisted single nodules/masses (21 cases) and multiple of nodules/masses (31 cases). There were total 206 lesions with 172 nodules and 34 masses. The lesions were mainly found in lower lobe(73.3%, 151/206)and outer zone or subpleura(87.4%, 180/206)of lung. Plain CT scan showed the densities of most lesions were solid and uniform(74.7%, 154/206). A total of 95 lesions were detected in the 19 patients with contrast enhanced CT, in which 61 lesions (64.2%) showed homogeneous enhancement and 86 lesions (90.5%) showed moderate enhancement. Nodular or mass-like lesions accompanied by many CT signs including halo sign (59.2%, 122/206), air bronchogram (32.0%, 66/206), pulmonary cavity or vocule sign (15.0%, 31/206), lobulation sign (25.2%, 52/206), spicule sign (13.1%, 27/206), pleural indentation(7.8%, 16/206) and vascular cluster (1.9%, 4/206). Compared with mass-like lesions, lobulation sign was more frequently observed in nodular lesions(χ2=13.750, P=0.001), whereas air bronchogram and pulmonary cavity orvocule sign were less frequently observed(χ2=19.957, P=0.001; χ2=5.295, P=0.021, respectively). No significant statistically differences were detected in other CT signs between them (P>0.05). Conclusions PC lesions usually occur in right lung, lower lobe and close to the pleura. Halo sign and air bronchogram are the characteristic findings of CT manifestations in nodular or mass-like type PC.

Objective To investigate the difference of morphology and blood flow of cavopulmonary anastomosis by MRI and that by ultrasonic cardiography (UCG) in patients with bidirectional Glenn shunt (BGS).Methods Phase-contrast MRI (PC-MRI) and contrast enhanced MRI (CE-MRI) were performed for superior vena cava ( SVC ) and inferior vena cava (IVC) in 22 patients with BGS on 3.0 T MR scanner.PC-MRI was used for measuring blood flow and CE-MRI for illustrating morphology.The width,peak flow velocity and gradient pressure of cavopulmonary anastomosis were calculated by using Report Card software.The similar data of UCG was collected.The parameters by MRI and that by UCG were compared statistically by t test and Pearson correlation.Results Based on the MRI data,the blood flow of SVC [ ( 1.002 ±0.208) L/min ] was significantly lower than that of IVC [ ( 1.794 ± 0.392 ) L/min ] ( t =- 15.148,P ＜0.01 ),while the regurgitation fraction of SVC [ (26.54 ± 12.82)％ ] was significantly higher than that ofIVC [ ( 17.44 ± 10.17)％ ] (t =11.060,P ＜0.01 ).The morphology displayed with MRI angiography couldnot be detected with UCG.The width of cavopulmonary anastomosis measured by MRI [ (12.46 ±3.43 ) mm ] was significantly higher than that of UCG[ ( 11.04 ± 2.63 ) mm] ( t =4.048,P ＜ 0.01 ),while the peak flow velocity of cavopulmonary anastomosis measured by MRI [ (47.77 ± 10.44) cm/s] was significantly lower than that of UCG [ (52.19 + 9.63) cm/s] ( t =- 2.237,P ＜ 0.05 ).No significant difference was found in gradient pressure of cavopulmonary anastomosis between the values by MRI [(0.95+0.42) mm Hg(1 mm Hg =0.133 kPa)] and that by UCG [(1.12+0.38)mm Hg] (t=2.010,P ＞ 0.05).The width,peak flow velocity and gradient pressure of cavopulmonary anastomosis by MRI were closely correlated with those by UCG (r =0.858,0.489,0.427,all P＜ 0.05 ).Conclusions A good correlation is found in the width,peak flow velocity,and gradient pressure of the cavopulmonary anastomosis obtained by 3.0 T MRI and UCG.MRI is more useful tool to display the width and abnormal morphology of cavopulmonary anastomosis than UCG.

Objective To evaluate the value of the change of B-type natriuretic peptide(BNP) in predicting weaning outcome of patients with mechanical ventilation in ICU.Methods We carried out a prospective cohort study on patients in ICU at Fuxing Hospital from July 2013 to January 2014.Patients expected to use mechanical ventilation for more than 24 hours were enrolled in our study.The plasma concentration of BNP was measured at the beginning of spontaneous breathing trial(SBT) and 2 hours after.According to the outcome of SBT,patients were divided into SBT failure group (group A),weaning failure group (group B) and weaning success group (group C).The levels of BNP before and after the SBT were compared among three groups.The receiver operating characteristic (ROC) curve analysis was used to evaluate the changes of BNP (△BNP) and the rate of change (△BNP％) in predicting weaning outcome.Results A total of 56 patients were enrolled in our study,12 in group A,11 in group B and 33 in groupC.In groupC,both△BNPand△BNP％ [7.0,(-1.2,45.5) ng/L;6.1 (-2.1,11.5)％]were significantly lower than those in group A [88.0 (58.0,140.0) ng/L,P ＜ 0.05;20.5 (15.3,40.3) ％,P＜0.001]and group B[46.0 (17.5,91.2) ng/L,P＜0.001;24.3(13.0,32.5) ％,P＜0.001].The area under ROC curve (AUC) of △BNP％ to predict weaning success was 0.88 [95％ CI 0.79-0.97;P ＜0.001] and the cut-off value is 13.4％ with relatively high sensitivity(84.8％)and specificity(82.6％).The AUC of △BNP to predict weaning success was 0.80 [95％ CI 0.69-0.92;P ＜ 0.001] and the cut-off value is 80ng/L with high sensitivity 93.4％ and mediocre specificity (47.9％).Conclusion Either △BNP％ or △BNP in the SBT can predict weaning outcome,in which △BNP％ seems better than △BNP.

Objective To explore the safety of total thyroidectomy surgery on patients with thyroid carcinoma. Methods From Jan 1986 to Dee 2006, clinical data of patients who underwent total thyroidectomy (total thyroidectomy group) and sub-total or near-total thyroidectomy surgery (control group) for thyroid carcinoma were retrospectively analyzed to identify the incidences of complications, recurrent laryngeal nerve paralysis (RNLP) and secondary hypoparathyroidism in the two groups. Results In the control group there were 433 thyroid carcinoma patients who underwent sub-total or near-total thyroidectomy. Transient unilateral RLNP(13 eases), permanent unilateral RLNP(5 eases), transient hypoparathyroidism (11 cases) was diagnosed. There was no permanent hypoparathyroidism in this group. In the 70 cases of thyroid carcinoma patients receiving total thyroidectomy, there were 4 eases suffering from transient unilateral RLNP, one case from permanent unilateral RLNP (P > 0.05), and there were 7 eases from transient hopyparathyroidim (P < 0.01), 2 eases from permanent hypoparathyroidism (P < 0.05). Conclusion The incidence of RLNP after total thyroidectomy was not higher than that after subtotal or near-total thyroideetomy. Postoperative hypocalcaemia was the most common postoperative complication of total thyroidectomy. It is our belief that total thyroidectomy should be performed in selected patients.